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To compare the satisfaction degree and pelvic floor manometry after pelvic floor muscle training isolated and associated with tibial nerve stimulation in women with mixed urinary incontinence (MUI).A randomized, single-blinded clinical trial was conducted. 24 women diagnosed with MUI were equally divided into two groups: pelvic floor muscle training isolated and associated to transcutaneous tibial nerve stimulation (TTNS). The study occurred in four stages: 1) evaluation: general information, pelvic floor manometry, the International Consultation on Incontinence Questionnaire - Urinary Incontinence - Short Form (ICIQ-UI-SF) and International Consultation on Incontinence Questionnaire - Overactive Bladder (OAB) application; 2) intervention: carried out over 2 months twice a week; 3) post-intervention evaluation: vaginal manometry, reapplication of the questionnaires and the Patient Global Impression (PGI) application at the end of the 2-month intervention; and, 4) follow-up: evaluation after 1 month of the end of the intervention. The primary outcome was the ICIQ-UI-SF and the secondary outcomes were ICIQ-OAB, vaginal manometry, and PGI. The repeated measures ANOVA was used to assess the time-to-group interaction by assigning a significance level of 5%.There was no interaction between time and group for ICIQ-UI-SF (p = 0.17) and manometry (p = 0.56). There was interaction for ICIQ-OAB (p 0.01). PGI was reported as "much better" with 41.67% in the PFMTG + TTNS and 16.67% in the PFMTG after the intervention (p = 0.04).The results showed weak evidence that TTNS, in combination with PFMT, may be an intervention that can be used to treat MUI. The satisfaction degree was better with associated intervention.

Aims To describe a pelvic floor muscle training (PFMT) isolated and associated with game therapy (PFMT + GT) for women facing mixed urinary incontinence (MUI) during climacteric period. Methods To standardize a randomized controlled clinical trial intervention, a protocol was created, in an attempt to decrease women's symptomatology generated by MUI, through pelvic floor and abdomino-loin-pelvic muscles strength, and endurance. This study protocol will be composed of 32 volunteers, divided into two groups of 16. They will perform PFMT isolated or PFMT + GT, twice a week during 8 weeks. Interventions will last 40 minutes and will be divided into warming (5 minutes), training (30 minutes), and 5 minutes will be composed of resting time between exercises (1 minute each). Isolated PFMT sessions will be performed through four modalities of exercises: diaphragmatic, bridge, abdominal (plank), and pelvic mobility. PFMT + GT training will be carried out by using Wii Fit Plus games, such as Lotus Focus, Penguin Slide, Basic Step, and Hula Hoop from Wii equipment. Assessments will occur before, after, and 1 month after interventions. Vaginal manometry, 1-hour Pad Test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and Patient Global Intervention (PGI) will be used to evaluate the sample. Conclusions It is expected greater increase on pelvic floor muscle (PFM) strength, endurance, vaginal pressure for PFMT + GG. Moreover, it is supposed that PFMT + GT volunteers present better treatment adherence due to games motivational inclusion.

Purpose: To translate, adapt and validate the International Consultation on Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms ICIQ-FLUTS for the Brazilian female population. Materials and Methods: A translation of the questionnaire into Brazilian Portuguese was made followed by an adaptation for better understanding by native speakers. After that, the ICIQ-FLUTS was answered by eighty volunteers (n=80) twice (for interviewers 1 and 2) with an interval of 30 minutes between them. Furthermore, after 15 days from the evaluation, the participants answered the ICIQ-FLUTS again in order to verify the questionnaire stability over time. The questionnaires Utian Quality Of Life (UQOL) and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), which are validated in Brazil were also applied to perform the validation. Results: The result of the Cronbach α coefficient of the instrument presented a value of 0.832. The values for test-retest were 0.907 (inter-observer) and 0.901 (intra-observer). The correlation between ICIQ-FLUTS (score I - domain of urinary incontinence) with the ICIQ-SF (final score) was strong and positive (r=0.836, p=0.000). In addition, the ICIQ-FLUTS showed moderate and negative correlation with the total score of UQOL (r=-0.691, p=0.017). Conclusion: The Portuguese version of the ICIQ-FLUTS questionnaire showed strong correlation to ICIQ-SF questionnaire and satisfactory values to test-retest and internal consistency.

Objective The aim of this trial was to investigate the effects of five consecutive sessions of anodal transcranial direct current stimulation (tDCS) over the motor cortex (M1) on pain, mood, and physical performance in patients with primary dysmenorrhea (PDM). Design This is a double-blind randomized controlled trial. Subjects Twenty-two participants with PDM according to the No. 345-PDM Consensus Guideline were included. Methods Eleven active treatment and 11 sham stimulation patients received five applications over a one-week period. The primary outcome measures were pain evaluated by numeric rating scale (NRS) and McGill Questionnaire score. Secondary outcomes measures were responses to the Positive and Negative Affect Schedule (PANAS), Hamilton Anxiety Scale (HAM-A), grip strength, and six-minute walk test (6MWT). Baseline data were performed during the first menstrual cycle, and during the second menstrual cycle, participants were conducted to tDCS treatment, and postintervention data were collected. Results The intervention provided significant improvements on NRS in active tDCS, shown as an interaction between group intervention vs pre/postintervention vs days of menstrual cycle (Wald x2 = 10.54, P = 0.005), main effect of days of menstrual cycle (Wald x2 = 25.42, P < 0.001), and pre/postintervention (Wald x2 = 6.97, P = 0.008). McGill showed an interaction effect between pre/postintervention and group of stimulation (Wald x2 = 18.45, P = 0.001), with a large reduction in active tDCS (P < 0.001, d = 0.75). Psychological and functional outcomes did not differ between groups or pre/postintervention. Conclusions tDCS could provide pain relief in subjects with PDM. These results provide some preliminary evidence for the potential role of tDCS as a contributor to the management of symptoms of PDM.

SUMMARY OBJECTIVE: To evaluate the sexual function of women in the puerperal period after a postpartum pelvic floor musculature training program. We also sought to evaluate correlations between sexual dysfunction in the women and their delivery type and compare the frequency of sexual dysfunction and the quality of resumed sexual function following vaginal and cesarean deliveries. METHODS: This clinical study included an intervention, carried out between July and December 2019, in which data were collected about 28 rooming-in women at a Maternity School. Data were divided into vaginal delivery and cesarean delivery. Sexual function was evaluated by the Female Sexual Function Index and the International Consultation on Incontinence Questionnaire-Short Form to assess the Incontinence Urinary and qualifies urinary loss. The intervention consisted of a muscle training exercise program. ANOVA tests were used to establish differences between groups. RESULTS: There was an improvement in all outcomes, but there was no time versus group interaction. Improvement in sexual function was observed (p

Infrared thermography (IRT) is an easy-to-use, noninvasive and pain-free tool that can be used to evaluate function of the pelvic floor (PF) muscles.To analyze vaginal manometry, temperature, and percentage of colors achieved through IRT of the PF muscles at rest and during maximum voluntary contraction. The relationship between PF muscles strength and IRT temperature was also assessed.Two-hundred and thirty-one women (mean ± SD age: 58.4±5.9 years) participated in this study. IRT recorded the minimum, average, and maximum temperatures, and the colors of the PF area at rest and during maximum voluntary contraction. The pressure applied during the three maximum voluntary PF contractions was evaluated through vaginal manometry.The women had a PF average temperature of 36.4 ± 0.8°C. There were no differences in the IRT temperatures between rest and during PF muscles contraction. The percentages of white, red, orange, yellow, green, cyan, and blue colors were different at rest and during contraction. Warm colors became more visible in the center of the image during the PF muscles maximum voluntary contraction. There was a positive correlation between the PF average temperature and PF manometry (r=0.7; p=0.001).The IRT was not able to detect differences in the temperature of the PF area between at rest and during contraction. However, a strong correlation between PF temperature and vaginal manometry was found.

This study aimed to evaluate the effect of low-level laser therapy (LLLT) on immediate postpartum pain relief during cesarean section. A randomized, parallel controlled trial was carried out. In total, 88 women with immediate postpartum were divided into 4 groups: control group (n = 22), placebo group (n = 22), experimental group I (n = 22, dose of 4 J/cm2), and experimental group II (n = 22, dose of 2 J/cm2). The pain measured by Numeric Rating Scale (NRS), algometry, and Global Change Perception Scale (GCPS) was assessed at 12, 20-24, and 44-48 h postpartum. Two LLLT sessions were performed at 12 and 24 h postpartum. A significant interaction was observed between time versus group for NRS F (2.40) = 36.80, p < 0.001 and algometry F (1.70) = 27.18, p < 0.001. GCPS revealed a significant difference between the groups during second (p = 0.04) and third evaluation (p = 0.04). The NRS and algometry presented a large effect size for the experimental groups. LLLT is an efficient method to reduce pain and enhance the GCP in postcesarean section. No significant clinical differences were found between the laser doses.

To analyze whether pelvic floor muscle training (PFMT) associated with weight loss (WL) is better than isolated PFMT to provide additional beneficial effects to urinary symptoms in women with MUI. A randomized, simple-blind parallel controlled trial was performed and included women with MUI aged between 40 and 65 years and body mass index between 25 and 40 kg/m2. The sample was randomized into two groups: 11 PFMT + WL and 11 PFMT. Data collection was performed in baseline and after interventions. The primary outcome was to investigate the loss of urine. Secondary aim includes PFM pressure and quality of life. PFMT was performed with two sets of eight repetitions in the first 4 weeks, and with three sets of eight repetitions in the final 4 weeks. The weight loss program was based on the calculation of total energy value needs. Data analysis was performed by SPSS 20.0 software and one-way ANCOVA. 22 volunteers participated in the study. There was no intergroup significant difference in post-intervention ICIQ-SF F(1, 19) = 7.115, p = 0.87, partial η2 = 0.001; manometry F(1, 19) = 0.608, p = 0.44, partial η2 = 0.003; pad test 1 h F(1, 19) = 0.185, p = 0.67, partial η2 = 0.01; QoL F(1, 19) = 1.018, p = 0.32, partial η2 = 0.05; and weight F(1, 19) = 0.251, p = 0.62, partial η2 = 0.01. Weight loss did not provide additional beneficial effects to PFMT in women with overweight or obesity grade I with MUI symptoms.

We aimed to assess the impact of social support on symptoms in Brazilian women with FM. An observational, descriptive study enrolling 66 women who met the 1990 American College of Rheumatology (ACR) criteria. Social support was measured by the Social Support Survey (MOS-SSS), functionality was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), depression was assessed using the Beck Depression Inventory (BDI), anxiety was measured using the Hamilton Anxiety Scale (HAS), affectivity was measured by Positive and Negative Affect Schedule (PANAS), and algometry was carried out to record pressure pain threshold (PPth) and tolerance (PPTo) at 18 points recommended by the ACR. Patients were divided into normal (NSS) or poor social support (PSS) groups with PSS defined as having a MOS-SSS score below the 25th percentile of the entire sample. Mann-Whitney or Unpaired t-test were used to compare intergroup variables and Fisher's for categorical variables. Analysis of covariance and Pearson correlation test were used. No differences in sociodemographic variables between PSS and NSS were found. Differences between NSS and PSS groups were observed for all four subcategories of social support and MOS-SSS total score. Significant differences between NSS and PSS on depression (p = 0.007), negative affect (p = 0.025) and PPTh (p = 0.016) were found. Affectionate subcategory showed positive correlation between pain and positive affect in PSS. Positive social interaction subcategory showed a negative correlation between FIQ and depression state. Therefore social support appears to contribute to ameliorate mental and physical health in FM.

Objective To develop a classification scale for manometry of pelvic floor muscles (PFM) in Brazilian women, according to the modified Oxford scale. Methods A cross sectional study, with 288 women enrolled in the Maternity, Natal, Brazil. Manometry and PFM strength data were collected and classified according to the modified Oxford scale. A simple linear regression was performed to determine the classification scale of manometry using the modified Oxford scale as the explanatory variable and the arithmetic mean of the manometry measurements as the response variable. Results The average age was 52.80 (±8.78; CI: 51.67-53.93) years. Manometry showed an average of 35.1 (±22.7; CI: 32.1-38.0) cmH2O and most women (29.7%) scored grade 3 on the modified Oxford scale. According to the proposed scale, values between 7.5 to 14.5 cmH2O correspond to very weak pressure; 14.6 to 26.5 cmH2O represent weak pressure; 26.6 to 41.5 cmH2O represent moderate pressure; 41.6 to 60.5 cmH2O represent good pressure, and values above 60.6 cmH2O correspond to strong pressure. Conclusion Manometry values were rated on a five-point scale. It is possible to rank the pressure levels performed by voluntary contraction of PFM with this new scale.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:26:24Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:42:09Z : No. of bitstreams: 1 2-s2.0-84859587854.pdf: 160345 bytes, checksum: a24fff4cb85fdbe48e2165b27caa2941 (MD5) Made available in DSpace on 2014-05-27T11:26:24Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-03-01 PURPOSE: To evaluate the importance of the oral glucose tolerance test for the diagnosis of glucose intolerance (GI) and type 2 diabetes mellitus (DM-2) in women with PCOS. METHODS: A retrospective study was conducted on 247 patients with PCOS selected at random. The diagnosis of GI was obtained from the two-hour oral glucose tolerance test with 75 g of glucose according to the criteria of the World Health Organization (WHO) (GI: 120 minutes for plasma glucose =140 mg/dL and

To evaluate the importance of the oral glucose tolerance test for the diagnosis of glucose intolerance (GI) and type 2 diabetes mellitus (DM-2) in women with PCOS.A retrospective study was conducted on 247 patients with PCOS selected at random. The diagnosis of GI was obtained from the two-hour oral glucose tolerance test with 75 g of glucose according to the criteria of the World Health Organization (WHO) (GI: 120 minutes for plasma glucose140 mg/dL and200 mg/dL), and the diagnosis of DM-2 was obtained by both the oral glucose tolerance test (DM: 120 minutes for plasma glucose200 mg/dL) and fasting glucose using the criteria of the American Diabetes Association (impaired fasting glucose: fasting plasma glucose100 and126 mg/dL; DM: fasting glucose126 mg/dL). A logistic regression model for repeated measures was applied to compare the oral glucose tolerance test with fasting plasma glucose. ANOVA followed by the Tukey test was used for the analysis of the clinical and biochemical characteristics of patients with and without GI and/or DM-2. A p0.05 was considered statistically significant.PCOS patients had a mean age of 24.8±6.3, and body mass index (BMI) of 18.3 to 54.9 kg/m² (32.5±7.6). The percentage of obese patients was 64%, the percentage of overweight patients was 18.6% and 17.4% had healthy weight. The oral glucose tolerance test identified 14 cases of DM-2 (5.7%), while fasting glucose detected only three cases (1.2%), and the frequency of these disorders was higher with increasing age and BMI.The results of this study demonstrate the superiority of the oral glucose tolerance test in relation to fasting glucose in diagnosing DM-2 in young women with PCOS and should be performed in these patients.

The polycystic ovaries syndrome (POS) is a heterogeneous endocrinal disorder prevalent in 5 to 10% of women in reproductive age. In POS, there is an association with risk factors linked to the development of cardiovascular disease such as insulin resistance, dislipidemia, diabetes mellitus, arterial hypertension, endothelial dysfunction, central obesity, metabolic syndrome and chronic pro-inflammatory markers. Physical exercise practice together with nutritional guidance have been recommended as first rate strategies in the treatment of oligomenorrhea, hirsutism, infertility and obesity in POS women. This way, the objective of the present review was to analyze the specific role played by exercise and/or physical activity in changes of the body shape, in biochemical and hormonal plasmatic levels, and in the POS women's reproductive function.