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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

IntroductionTo assess whether obesity has a greater impact than overweight on urinary incontinence severity, pelvic floor muscle function, and quality of life in women with urinary incontinence. MethodsA pilot cross-sectional study using a convenience sample. Twenty-six volunteers were evaluated and divided into: Overweight Group (n=11) with BMI (body mass index) between 25.0-29.9kg/m²; Obesity Group (n=15) BMI≥30.0kg/m². The volunteers performed the urogynecological evaluation, Incontinence Severity Index (ISI), the King’s Health Questionnaire (KHQ), 1-hour pad test and evaluation of pelvic floor muscle function. Statistical analysis: Shapiro–Wilk test and the Mann-Whitney test for intergroup analysis. The significance level: p≤0.05. ResultsThe average age was 61.09(12.51) in the Overweight Group and 55.93(9.03) years in the Obesity Group. The Overweight Group presented better fast fiber contraction (p=0.03) of the pelvic floor muscle. There were no differences in the ISI and quality of life between the groups. ConclusionsThere was no difference in the impact caused by being overweight or obese in relation to urinary incontinence severity, pelvic floor muscle function and quality of life, except for fast fiber contraction in which Overweight Group showed better results.

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.

Introdução: A mulher climatérica apresenta fraqueza muscular que pode gerar disfunções pélvicas. Aparentemente a prática regular de atividade física nesse período promove uma melhora da função muscular global. Objetivo: avaliar a função da musculatura do assoalho pélvico (MAP) de acordo com nível de atividade física em mulheres climatéricas. Métodos: estudo observacional, analítico e transversal. A amostra foi composta por 457 mulheres divididas de acordo com o nível de atividade física. A coleta de dados ocorreu através da aplicação da ficha de avaliação, aplicação do Questionário Internacional de Atividade Física (IPAQ), e avaliação por meio da palpação vaginal e manometria da MAP. Para análise estatística foram usados os testes de Kolmogorov-Smirnov, ANOVA, qui-quadrado e correlação de Pearson. Resultados: As mulheres classificadas como muito ativas obtiveram uma pressão média de 45,24cmH2O, as ativas apresentaram 29,03cmH2O e as sedentárias 27,20cmH2O, com diferença estatística entre os grupos (p=0,003). Conclusão: Quanto mais ativa for a mulher climatérica, melhor será a função da MAP.

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. RESUMO Objetivou-se avaliar o impacto do apoio social sobre os sintomas de mulheres brasileiras com fibromialgia (FM). Trata-se de um estudo observacional descritivo que selecionou 66 mulheres que atendiam aos critérios do Colégio Americano de Reumatologia (ACR) de 1990. O apoio social foi medido com o Social Support Survey (MOS-SSS), a funcionalidade com o Questionário do Impacto da Fibromialgia (FIQ), a depressão com o Inventário de Depressão de Beck (BDI), a ansiedade com a Escala de Ansiedade de Hamilton (HAS), a afetividade com o Positive and Negative Affect Schedule (Panas) e foi feita algometria para registrar o limiar da dor à pressão (LDP) e a tolerância álgica à pressão (TAP) nos 18 pontos recomendados pelo ACR. Os pacientes foram divididos nos grupos apoio social normal (ASN) ou ruim (ASR); o ASR foi definido como uma pontuação nos MOS-SSS abaixo do percentil 25 da amostra total. Usou-se o teste de Mann-Whitney ou o teste t não pareado para comparar variáveis intergrupos e o de Fisher para as variáveis categóricas. Usaram-se a análise de covariância e o teste de correlação de Pearson. Não houve diferença nas variáveis sociodemográficas entre os grupos ASN e ASR. Observaram-se diferenças entre os grupos ASN e ASR para todas as quatro subcategorias de apoio social e pontuação total do MOS-SSS. Encontraram-se diferenças significativas entre o ASN e o ASR na depressão (p = 0,007), afeto negativo (p = 0,025) e LDP (p = 0,016). A subcategoria apoio afetivo mostrou correlação positiva entre a dor e o afeto positivo no grupo ASR. A subcategoria interação social positiva mostrou uma correlação negativa entre o FIQ e o estado de depressão. Portanto, o apoio social parece contribuir para a melhoria na saúde mental e física na FM.

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.

BACKGROUND AND OBJECTIVES: Abdominal and pelvic pain is a prevalent condition among women in the immediate postpartum period. Non-pharmacological therapies are of great importance for the treatment of this condition since they do not cause systemic side effects, such as drowsiness, irritability, and changes in the composition of breast milk. This article aims to identify and evaluate the efficacy of non-pharmacological analgesic therapies used in the immediate puerperium in abdominal-pelvic pain. CONTENTS: Searches were carried out in the main databases from September to October 2017 using the following descriptors "treatment" AND "pain" AND "postpartum"; "Treatment" AND "pain" AND "postpartum" AND "analgesics" AND "non-pharmacological". Controlled and randomized clinical trials published between January 2007 and August 2017, in Portuguese, English, and Spanish were included. Of the 1737 studies found in the databases, 42 were selected by the title. According to the eligibility criteria, 13 studies were included. The total sample size of the studies ranged from 21 to 266. In the intervention groups, the sample ranged from 11 to 126 women who underwent cryotherapy, transcutaneous electrical stimulation, LASER, acupuncture and ear acupressure. CONCLUSION: Interventional practices such as transcutaneous electrical nervous stimulation and cryotherapy presented significant data relevant to the reduction of abdominal and pelvic pain. The techniques of acupuncture and ear acupressure still present inconclusive data. Despite the relief of perineal pain, laser therapy showed no statistically significant effect on pain relief when compared to the placebo group. RESUMO JUSTIFICATIVA E OBJETIVOS: Dor abdominal e pélvica são condições prevalentes entre as puérperas no período pós-parto. As terapias não farmacológicas nesses casos são de grande importância, tendo em vista a ausência de efeitos adversos sistêmicos, tais como sonolência, irritabilidade e modificações no leite materno. O objetivo deste estudo foi identificar e avaliar a eficácia das terapias analgésicas não farmacológicas utilizadas no puerpério imediato na dor abdominal e pélvica. CONTEÚDO: Realizou-se buscas nas principais bases de dados, no período de setembro a outubro de 2017, utilizando-se as combinações: "treatment" AND "pain" AND "postpartum"; "treatment" AND "pain" AND "postpartum" AND "analgesics" AND "non-pharmacological". Foram incluídos ensaios clínicos controlados e randomizados, publicados no período de janeiro de 2007 a agosto de 2017, nos idiomas português, inglês e espanhol. Dos 1.737 estudos encontrados nas bases de dados, 42 foram selecionados pelo título. De acordo com os critérios de elegibilidade, incluiu-se 13 estudos. O tamanho total das amostras dos estudos variou entre 21 e 266. Nos grupos com intervenção, a amostra variou entre 11 e 126 mulheres que foram submetidas a crioterapia, estimulação elétrica nervosa transcutânea, LASER, acupuntura e auriculoterapia. CONCLUSÃO: As práticas intervencionistas como a eletroestimulação elétrica nervosa transcutânea e a crioterapia apresentaram dados significativos relevantes na redução da dor abdominal e pélvica. As técnicas de acupuntura e auriculoterapia ainda apresentam dados inconclusivos. Apesar de provocar alívio da dor perineal, a laserterapia não mostrou efeito estatisticamente significativo para alívio da dor quando comparada com o grupo placebo.

Introdução: O trabalho de parto consiste em um evento único e complexo que envolve vários fatores biopsicossociais. A dor experimentada na parturição é uma resposta fisiológica e complexa aos estí­mulos sensoriais. Objetivo: Realizar revisão sistemática sobre os efeitos dos recursos fisioterapêuticos aplicados para o alí­vio da dor durante o trabalho de parto. Material e métodos: Foi realizada uma revisão sistemática, buscando artigos nas bases de dados Scielo, Medline, Bireme e Lilacs, com estudos publicados até 2014. Utilizaram-se os Descritores em Ciências da Saúde (DeCS) ou sinônimos em português e inglês. Resultados: Foram encontrados 49 artigos e selecionados 13 para análise. A mediana do ní­vel de evidência PEDro foi 8. Foi encontrada uma variedade de intervenções: massoterapia, TENS, exercí­cios na bola, banho de imersão, exercí­cios respiratórios, acupuntura, deambulação, mobilidade e banho de chuveiro. Conclusão: Os estudos sugerem que as técnicas fisioterapêuticas investigadas, em sua maioria, contribuí­ram de forma benéfica para alí­vio da dor das parturientes. No entanto, alguns achados demonstraram resultados inconclusivos acerca da eficácia das técnicas.Palavras-chave: analgesia, salas de parto, gestantes, massagem.

Introducao: Existem fatores de risco para sintomas urinarios, que sao associados ao parto. O objetivo deste estudo foi investiga a presenca de sintomas urinarios no pos-parto. Metodos: Foi realizado um estudo de coorte prospectivo. As voluntarias foram avaliadas em tres momentos. A primeira entrevista foi face-a-face em dois dias apos o parto. Com duas e oito semanas apos o parto, as pacientes foram avaliadas por telefone. Resultados: 132 mulheres foram alocadas em dois grupos de acordo com o tipo de parto: VG (parto vaginal) e CG (parto cesareo). A media de idade das mulheres foi 24.54 (±5.65) anos no VG e 25.23 (±5.26) no CG (p = 0.869). O sintoma mais frequente nos dois grupos foi a nocturia. Conclusao: os sintomas urinarios tendem a agravar-se ao longo do periodo de pos-parto, independente do tipo de parto.

[Purpose] To assess lower urinary tract symptoms in different stages of menopause and the quality of life of females with incontinence. [Subjects and Methods] The sample consisted of 302 females, aged between 40 and 56 years, divided into three groups: PRE (n= 81), PERI (n= 108) and POST (n= 113). This was a cross-sectional, analytical, observational study. Data were collected by assessment chart and conducting the International Consultation on Incontinence Questionnaire-Short Form. [Results] Most of the women had less than 10 years of schooling and were married. In PERI and POST menopause, the most frequent lower urinary tract symptoms were urinary urgency and stress incontinence. The PRE group did not exhibit nocturia, urge incontinence or urinary urgency, and had the lowest symptoms frequency. In the three stages, stress incontinence was the most prevalent symptom. Of the three menopause stages, PERI had a greater impact on urinary incontinence according to the International Consultation on Incontinence Questionnaire. [Conclusion] The presence of lower urinary tract symptoms can vary across the different stages of menopause and the urinary incontinence was the most frequent complaint. Moreover, it was observed that quality of life was more affected in the perimenopause stage.

Aims To evaluate the electrical activity of the pelvic floor muscles (PFM) in women with polycystic ovary syndrome. Methods Forty-two women with polycystic ovary syndrome (PCOS group) and 13 premenopausal women (control group) were recruited in this cross-sectional study. Total testosterone and estradiol were measured and muscle tone and maximum voluntary contraction (MVC) of PFM were determined by surface electromyography. Results There was a difference in muscle tone (PCOS = 59.9 µV and Control group = 25.5 µV; P

O avanco crescente dos dispositivos tecnologicos na area da saude tem trazido metodos de avaliacao, testes e exercicios cada vez mais eficientes e precisos. Na area de avaliacao da contracao da musculatura do assoalho pelvico (MAP), o uso da perineometria tem sido preferido pelos fisioterapeutas porque e um metodo de aplicabilidade efetiva e simples. Neste contexto, identificou-se a ausencia nas praticas clinicas do uso de um instrumento com biofeedback, que tenha uma interface interativa para realizacao das sessoes de reabilitacao aplicado em perineometria. Assim, este trabalho tem como objetivo principal apresentar o design e o desenvolvimento de um sistema sem fio de aquisicao de sinais perineometricos (SASP) via Wi-Fi dotado de uma interface grafica, que permite o biofeedback de audio e visual, auxiliado por uma interface grafica de usuario que possibilita o biofeedback em tempo real, facilitando o progresso da avaliacao fisica do individuo.

[Purpose] To evaluate the electrical activity of the pelvic floor muscle in women during the follicular, ovulatory, and luteal phases of the menstrual cycle and its correlation with estradiol and total testosterone levels. [Subjects and Methods] This cross-sectional study involved 30 women with ovulatory menstrual cycles. Total testosterone and estradiol levels were measured and the muscle tone and maximum voluntary contraction of the pelvic floor muscles were evaluated using surface electromyography. [Results] Muscle tone was significantly lower during the follicular (21.1±3.3 μV) and ovulatory (27.1±5.9 μV) phases than the luteal phase (30.4±4.1 μV). The maximum voluntary contraction was not different across phases. The estradiol level on the 7th day of the menstrual cycle showed a strong positive correlation with muscle tone and maximum voluntary contraction, and the testosterone level was positively correlated with muscle tone on the 21st day. [Conclusion] Women have better muscle tone during the luteal phase. The muscle tone and maximum voluntary contraction were strongly correlated with the estradiol level on the 7th day, and the muscle tone was correlated with the testosterone level on the 21st day of the menstrual cycle. These findings suggest that hormonal fluctuations during the menstrual cycle alter pelvic floor muscle activity.

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.

Maria Clara Eugênia de Oliveira,Larissa Ramalho Dantas Varella,Priscylla Helouyse melo Angelo,Maria Thereza Albuquerque Barbosa Cabral Micussi Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil Purpose: The aim of the study is to evaluate the pressure of the pelvic floor muscles (PFM) according to waist circumference (WC) and correlate the presence of urinary tract symptoms (UTS) with WC. Patients and methods: The study was observational and cross-sectional. One-hundred and sixty-four females between 45 and 65 years of age were evaluated. The sample was divided into two groups, according to WC: Group ≤80 (G≤80) was composed of females in whom WC was up to 80cm; and Group >80 (G>80) was composed of females with WC above 80cm. The subjects were assessed in terms of sociodemographic data, pre-existing conditions, urogynecological and obstetric history, and the presence of lower UTS (LUTS), as well as physical examination, measurement of WC, height, and weight. The PFM assessment was made by perineometry. To compare the mean between groups, the independent samples t-test was applied, and to correlate the WC with perineometry and LUTS, the Pearson’s correlation test was used. Results: The final sample was composed of 156 patients. The average age of participants was 55.21 (±24.5) years in G≤80 and 57.23 (±6.12) years in G>80. There were significant differences regarding the presence of LUTS between the groups (P80. There was a correlation between the presence of urinary urgency (r=0.7; P=0.00), nocturia (r=0.7; P=0.00), and urinary incontinence (r=0.9; P=0.00) with WC. Conclusion: Females with larger abdominal diameter have a higher prevalence of LUTS such as urinary incontinence, nocturia, and urinary urgency, as well as a lower PFM pressure. Furthermore, a relationship between LUTS with WC was also observed. Keywords: abdominal obesity, pelvic floor, urinary incontinence, females

Objetivo Analisar a prevalência da síndrome metabólica (SM) nos estágios pubertários de escolares do sexo feminino. Métodos Estudo transversal com 449 escolares, entre oito e 18 anos, estratificadas nos estágios pubertário, índice de massa corporal (IMC) e percentual de gordura (%G). A SM foi classificada pela International Diabetes Federation. A análise feita pela distribuição de frequências, intervalos de confiança (95 %), Qui-quadrado e razão de chance para associações. Resultados A prevalência de SM foi 3,3 % (IC:2 %-5 %), sendo 2,5 % (IC:0,1 %-5%) no púbere e 7,9 % (IC:3,2 %-12,6 %) no pós-púberes, com associação significante destes com a SM (X2=5,2 [p

Maria Thereza Micussi,1 Rodrigo Pegado Freitas,1 Priscylla Helouyse Angelo,2 Elvira Maria Soares,3 Telma Maria Lemos,4 Técia Maria Maranhão51Physical Therapy Department, 2Postgraduate Program in Physical Therapy, 3Januário Cicco Maternity School, 4Clinical Analysis Department, 5Tocogynecology Department, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, BrazilPurpose: The aim of this study was to evaluate the pelvic floor muscles (PFMs) in women with insulin resistance (IR) using surface electromyography and to associate the results with insulin levels.Patients and methods: Through an analytical, cross-sectional study, 86 women were evaluated and divided into two groups: a control group (n=35) and an IR group (n=51). Data were collected through detailed history-taking, physical examination, and biochemical analysis. Fasting insulin levels were used for diagnosing IR. Electromyography of the PFMs was used for analyzing the tone and maximal voluntary contraction (MVC). The measures of central tendency and linear regression models were used.Results: The average age was 25.3±4.5 years in the IR group and 27.2±4.4 years in the control group. The mean weight was 75.6±17.6 kg and 51.8±4.9 kg in the IR and control groups, respectively. Fasting insulin levels were 19.7±6.6 µIU/mL in the IR group and 5.4±1.8 µIU/mL in the control group (P

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

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:50:35Z No. of bitstreams: 1 S0100-72032012000200006.pdf: 198368 bytes, checksum: da2a174175e38786e478f4a4e381f38f (MD5) Made available in DSpace on 2013-08-22T18:50:35Z (GMT). No. of bitstreams: 1 S0100-72032012000200006.pdf: 198368 bytes, checksum: da2a174175e38786e478f4a4e381f38f (MD5) Previous issue date: 2012-02-01 Made available in DSpace on 2013-09-30T18:21:02Z (GMT). No. of bitstreams: 2 S0100-72032012000200006.pdf: 198368 bytes, checksum: da2a174175e38786e478f4a4e381f38f (MD5) S0100-72032012000200006.pdf.txt: 31608 bytes, checksum: 96996fad334abbcf598b776703a3c63d (MD5) Previous issue date: 2012-02-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:35:50Z No. of bitstreams: 2 S0100-72032012000200006.pdf: 198368 bytes, checksum: da2a174175e38786e478f4a4e381f38f (MD5) S0100-72032012000200006.pdf.txt: 31608 bytes, checksum: 96996fad334abbcf598b776703a3c63d (MD5) Made available in DSpace on 2014-05-20T13:35:50Z (GMT). No. of bitstreams: 2 S0100-72032012000200006.pdf: 198368 bytes, checksum: da2a174175e38786e478f4a4e381f38f (MD5) S0100-72032012000200006.pdf.txt: 31608 bytes, checksum: 96996fad334abbcf598b776703a3c63d (MD5) Previous issue date: 2012-02-01 OBJETIVO: Analisar a prevalência de resistência à insulina de acordo com diferentes medidas antropométricas e bioquímicas em mulheres com síndrome dos ovários policísticos. MÉTODOS: Foram analisadas, retrospectivamente, 189 pacientes com síndrome dos ovários policísticos. O diagnóstico de resistência à insulina foi obtido utilizando-se insulinemia, HOMA-IR, QUICKI, índice de sensibilidade à insulina e relação glicemia/insulina. Foram utilizados o índice de massa corpórea e o lipid accumulation product. Para análise dos resultados, aplicou-se a estatística descritiva, a ANOVA, o pós-teste de Tukey e a correlação de Pearson. RESULTADOS: As pacientes apresentaram média de idade de 24,9±5,2 e de índice de massa corpórea de 31,8±7,6. O percentual de pacientes obesas foi de 57,14%. Dentre os métodos de investigação de resistência à insulina, o índice de sensibilidade à insulina foi a técnica que mais detectou (56,4%) a presença de resistência à insulina nas mulheres com síndrome dos ovários policísticos. em 87% das pacientes obesas, detectou-se a resistência à insulina. A relação glicemia/insulinemia de jejum e o índice de sensibilidade à insulina apresentaram correlação forte com o lipid accumulation product. CONCLUSÃO: A prevalência de resistência à insulina variou de acordo com o método utilizado e foi maior quanto maior o índice de massa corpórea. O lipid accumulation product também está relacionado à resistência à insulina. PURPOSE: To analyze the prevalence of insulin resistance, according to different biochemical and anthropometric measurements in women with polycystic ovary syndrome. METHODS: A total of 189 patients with polycystic ovary syndrome were retrospectively analyzed. Insulin resistance diagnosis was performed using fasting insulin, HOMA-IR, QUICKI, insulin sensibility index and glucose/fasting insulin ratio. Body mass index and lipid accumulation product were used. Data were analyzed statistically by descriptive statistics, ANOVA, Tukey post-test, and Pearson's correlation. RESULTS: The polycystic ovary syndrome patients had a mean age of 24.9±5.2 and a mean body mass index of 31.8±7.6. The percentage of obese patients was 57.14%. Among the methods of insulin resistance investigation, the insulin sensibility index was the technique that most detected (56.4%) the presence of insulin resistance in women with polycystic ovary syndrome. The insulin resistance was detected in 87% of obese patients. The fasting glucose/fasting insulin ratio and insulin sensibility index were strongly correlated with lipid accumulation product. CONCLUSION: The prevalence of insulin resistance varied according to the method used, and it was greater the higher the body mass index. Lipid accumulation product was also related to insulin resistance. Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Universidade Federal de Uberlândia (UFU) Departamento de Tocoginecologia Universidade Federal do Rio Grande do Norte (UFRN) Departamento de Fisioterapia Universidade Federal do Rio Grande do Norte (UFRN) Departamento de Tocoginecologia Universidade Estadual Paulista Júlio de Mesquita Filho Departamento de Clínica Médica Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina de Botucatu Departamento de Ginecologia e Obstetrícia Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina Universidade Estadual Paulista Júlio de Mesquita Filho Departamento de Clínica Médica Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Medicina de Botucatu Departamento de Ginecologia e Obstetrícia

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.

A síndrome dos ovários policísticos (SOP) é uma desordem endócrina heterogênea com prevalência de 5 a 10% nas mulheres em idade reprodutiva. Na SOP, há associação com vários fatores de risco para desenvolvimento de doença cardiovascular, como resistência à insulina, dislipidemia, diabetes mellitus, hipertensão arterial, disfunção endotelial, obesidade central, síndrome metabólica e marcadores pró-inflamatórios crônicos. A prática de exercício físico, juntamente com orientação nutricional, tem sido recomendada como estratégia de primeira linha no tratamento da oligomenorréia, hirsutismo, infertilidade e obesidade nas mulheres com SOP. Nesse sentido, o objetivo da presente revisão foi analisar o papel específico do exercício e/ou atividade física nas modificações da composição corporal, sistema cardiovascular, níveis plasmáticos bioquímicos e hormonais e função reprodutiva de mulheres com SOP. 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.

Objetivo Avaliar a influencia da fisioterapia pre-operatoria na amplitude de movimento do ombro e na medida de independencia funcional em mulheres submetidas a mastectomia radical modificada com linfadenectomia axilar. Metodos Foi realizado estudo piloto de um ensaio clinico randomizado com 14 mulheres que realizaram cirurgia de mastectomia radical com linfadenectomia axilar, divididas em grupo-controle (n=7) e grupo intervencao (n=7). As avaliacoes ocorreram no momento pre-operatorio, no pos-operatorio imediato (1° dia pos-operatorio) e no pos-operatorio tardio (15o dia pos-operatorio), atraves de fichas de avaliacao fisioterapeutica e aplicacao do medida de independencia funcional. Para o grupo intervencao, foi realizado atendimento fisioterapeutico pre-operatorio, atraves de cinesioterapia do ombro. Para o grupo-controle, foram dadas somente informacoes atraves de cartilha como intervencao no pre-operatorio. Resultados A idade media das mulheres do grupo-controle foi de 61,1 (±14) e no grupo intervencao foi de 64,3 (±11,1) anos ( p =0,65). Observou-se que o movimento de abducao do ombro apresentou maior deficit de amplitude de movimento para o grupo-controle. Com relacao a medida de independencia funcional, demonstrou-se uma diferenca significativa ( p