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Introduction and Hypothesis: The objective was to cross-culturally adapt and check for the reliability, internal consistency, and validity of the Nocturia Quality of Life Questionnaire (N-QoL) in Brazilian Portuguese (N-QoL-Br). Methods: The questionnaire was translated according to international guidelines, included forward-translation, back-translation, and consensus among an expert committee. Participants with nocturia completed the Pittsburgh Sleep Quality Index, International Consultation on Incontinence Questionnaire Overactive Bladder, and the General Quality of Life Assessment Questionnaire SF-36 (Medical Outcomes Study 36–Item Short-Form Health Survey), in addition to the N-QoL-Br. The Brazilian version was applied in men and women with nocturia twice within a range of 4 weeks. Psychometric properties such as content validity, construct validity, internal consistency, and test–retest reliability were tested. Results: Content validity was considered adequate. Eighty-four men and women participated in the study. Good internal consistency in the domains and final score of the N-QoL-Br was observed, with Cronbach α greater than 0.9. The test–retest reliability was also high, with an intraclass correlation coefficient greater than 0.9 for the domain sleep/energy, bother/concern, and total score (0.98, 0.98, and 0.97 respectively). Conclusions: The Portuguese version of the N-QoL-Br presents good internal consistency and reproducibility and it can be considered adequate and valid for evaluating the impact of nocturia on the quality of life of men and women in the Brazilian population. [ABSTRACT FROM AUTHOR]

During pregnancy, biomechanical changes are observed due to hormonal and physical modifications, which can lead to alterations in the curvature of the spine, balance, gait patterns, and functionality of the pelvic floor muscles. This study aimed to investigate the progressive impact of biomechanical changes that occur during gestational weeks on the myoelectric activity of the pelvic floor muscles, plantar contact area, and functional mobility of high-risk pregnant women. Methods: This was a cross-sectional observational study carried out from November 2022 to March 2023. A total of 62 pregnant women of different gestational ages with high-risk pregnancies were analyzed using surface electromyography to assess the functionality of the pelvic floor muscles, plantigraphy (Staheli index and plantar contact area), and an accelerometer and gyroscope using the timed up and go test via an inertial sensor on a smartphone. Descriptive statistics and multivariate linear regression analyses were carried out to test the predictive value of the signature. Results: Increasing weeks of gestation resulted in a decrease in the RMS value (β = −0.306; t = −2.284; p = 0.026) according to the surface electromyography analyses. However, there was no association with plantar contact (F (4.50) = 0.697; p = 0.598; R2 = 0.53). With regard to functional mobility, increasing weeks of gestation resulted in a decrease in time to standing (β = −0.613; t = −2.495; p = 0.016), time to go (β = −0.513; t = −2.264; p = 0.028), and first gyrus peak (β = −0.290; t = −2.168; p = 0.035). However, there was an increase in the time to come back (β = 0.453; t = 2.321; p = 0.025) as the number of gestational weeks increased. Conclusions: Increased gestational age is associated with a reduction in pelvic floor myoelectric activity. The plantar contact area did not change over the weeks. Advancing gestation was accompanied by a decrease in time to standing, time to go, and first gyrus peak, as well as an increase in time to come back. [ABSTRACT FROM AUTHOR]

The pelvic floor requires an integrated anatomical structure owing to its multiple functions. Therefore, it is necessary to study methods for improving muscle recruitment during training. This study aimed to analyze the effect of using an innovative vaginal trainer on the bioelectrical activity of the pelvic floor muscles. Pelvic positioning and interference factors, such as age, childbirth, sexual activity, urinary incontinence, and menopause, were also analyzed. A cross-sectional study assessed 30 women using an evaluation form, International Consultation on Incontinence Questionnaire-Short Form, and surface electromyography. The root mean square of a 5-second contraction period, peak root mean square values, area values, % maximal voluntary contraction (root mean square normalized by peak signal), and median frequency were collected. These findings with and without the use of a vaginal educator were compared in the anteversion, neutral, and retroversion pelvic positions. The use of a vaginal educator was found to increase the electromyographic activity of the pelvic floor muscles in the neutral position. In this position, older women showed an increased peak contraction when using the educator. Multiparas also benefited from increased bioelectric activity (root mean square and area). Sexually active women increased their bioelectric activity in a neutral position when using the trainer, exerting less effort in retroversion (%-maximal voluntary contraction). Incontinent and menopausal women exhibited slower body-building activation (decreased frequency) with the device, which requires further investigation. Our innovative biofeedback device induced greater recruitment of muscle fibers, is more effective in the neutral pelvic position, and may be effective in training the pelvic floor muscles, even in women with a greater tendency toward pelvic floor dysfunction. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia (FM) is characterized by chronic and widespread pain, sleep disturbances, fatigue, psychological distress and morning stiffness. These patients also present symptoms such as depression, sexual dysfunctions and reproductive problems. Sexuality involves several aspects, including pelvic floor functionality, and one question is whether the sexual performance of women with fibromyalgia is associated with pelvic floor function or other characteristics of the disease. Objective: The aim of this study was to gauge the association between perineal function and sexual performance in women with and without fibromyalgia. Methods: We performed a cross-sectional study with 109 sexually active women from 19 to 65 years of age, either suffering from fibromyalgia (FM group, n = 51) or free from fibromyalgia (non-FM group, n = 58). Perineal function was measured with the use of perineometry and digital vaginal palpation (PERFECT Scheme), while sexual performance was assessed by the Sexual Quotient Female questionnaire (QS-F). Results: Patients with fibromyalgia presented poor sexual performance compared to those without fibromyalgia (QS-F score 58 (32–66) vs. 66 (56–70); p = 0.002) as well as lower pelvic floor muscle strength measured by perineometry (32.5 (18.2–40.5) vs. 37.9 (23.4- 57.3); p = 0.03). Patients without fibromyalgia presented a positive correlation between perineometry and QS-F (r = 0.22; p = 0.038), while those with fibromyalgia presented no correlation between those two variables (r = 0.22; p = 0.12). The regression model showed an association between sexual performance and the presence of fibromyalgia, pelvic floor muscle strength (perineometry) and age, according to the following equation: sexual performance = 48.52 + (9.5 * non-FM group) + (0.23 * perineometry)–(0.4 * age), with adjusted R2 = 0.19. Conclusion: Women with FM present poor sexual performance and lower pelvic floor muscle strength compared to those without FM. However, the correlation between these variables among women without FM was not observed in women with FM. Sexual performance showed a positive association with absence of fibromyalgia and higher pelvic floor muscle strength, and a negative association with age. [ABSTRACT FROM AUTHOR]

Introduction and aim: Physiotherapy in urogynecology faces challenges to safely continuing its work, considering the adoption of social distancing measures during the COVID-19 pandemic. Some guidelines have already been published for urogynecology; however, no specific documents have been produced on physiotherapy in urogynecology. This article aimed to offer guidance regarding physiotherapy in urogynecology during the COVID-19 pandemic. Methods: A group of experts in physiotherapy in women's health performed a literature search in the Pubmed, PEDro, Web of Science and Embase databases and proposed a clinical guideline for physiotherapy management of urogynecological disorders during the COVID-19 pandemic. This document was reviewed by other physiotherapists and a multidisciplinary panel, which analyzed the suggested topics and reached consensus. The recommendations were grouped according to their similarities and allocated into categories. Results: Four categories of recommendations (ethics and regulation issues, assessment of pelvic floor muscle function and dysfunction, health education and return to in-person care) were proposed. Telephysiotherapy and situations that need in-person care were also discussed. Regionalization is another topic that was considered. Conclusion: This study provides some guidance for continuity of the physiotherapist's work in urogynecology during the COVID-19 pandemic, considering the World Health Organization recommendations and the epidemiological public health situation of each region. Telephysiotherapy can also be used to provide continuity of the care in this area during the COVID-19 pandemic, opening new perspectives for physiotherapy in urogynecology. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: A voiding diary is a method to investigate lower urinary tract symptoms. The purpose was to elaborate a descriptive analysis of nonpaid voiding diaries for mobile applications and to compare them regarding their quality. Methods: We searched the platforms of iTunes (Apple Inc., Brazil) and Google Play (Google Inc., Brazil) using the keywords: "voiding diary," "bladder diary," "urinary diary," "urinary incontinence," and "pelvic floor." Inclusion criteria were: apps free of charge and specific for voiding diaries in the Portuguese, Spanish, French, or English language. Exclusion criteria were: access or technical problems and pediatric apps. We quantitatively analyzed and compared the apps with each other according to their functionality features and voiding diary topics (type and volume of fluid intake, voiding episodes and volume, type and episodes of incontinence, amount of leakage, urgency, and use of pads and nocturia). We rated the apps using the Mobile App Rating Scale (MARS), whose scores for each feature vary from 1 (worst score) to 5 (best score). Results: Fifty-five apps were eligible; 16 were included for analyses. None presented all 11 topics of the voiding diary, and the median number of available features was 6 (3.75–7). "Incontinence episodes" was present in eight apps, and "nocturia" was present in five. The mean score of apps ranged between 1.7 and 4.5. Conclusion: There is variation in the content of voiding topics among the apps. Patients and professionals should choose the app based on the topics of most or particular interest. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Fibromyalgia (FM) studies have focused on pain, but a 2010 review of the diagnostic criteria pointed to other symptoms including urinary incontinence (UI). Women with FM present pain, fatigue, and reduced muscle strength; the research hypothesis was that pelvic floor (PF) muscles would be weaker; therefore, FM could be associated with lower urinary tract symptoms (LUTS) and compromise quality of life (QoL). The aim of this paper was to compare PF function, urinary symptoms, and their impact on QoL in women with and without FM and to verify if there is association between FM and LUTS. Methods: We performed a cross-sectional study with 126 sexually active women aged between 19 and 65 years old, distributed in two groups, women with FM (FG n = 62) and without FM (NFG n = 64). Perineal function was the primary outcome and was assessed by perineometry and bidigital vaginal palpation (PERFECT Scheme). Presence of LUTS was assessed by interview based on international definition, and the impact of UI on QoL was evaluated by the King's Health Questionnaire (KHQ). Results: FG presented worse PF function on clinical exam (p < 0.001) and perineometry (p = 0.04). LUTS was more frequent among FG (p < 0.001). In terms of QoL, FG obtained lower KHQ scores for general health perception (p < 0.001) and sleep/energy (p < 0.003) domains. The odds of presenting LUTS is 5.03 (95%CI 2.35–10.75) higher in women with FM. Conclusion: Women with FM had worse perineal function, had more LUTS, and presented UI more frequently, which negatively impacts on QoL. [ABSTRACT FROM AUTHOR]