An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o
Autor(a) principal: | |
---|---|
Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da Uninove |
Texto Completo: | http://bibliotecatede.uninove.br/handle/tede/1891 |
Resumo: | Contextualization: Weakening of pelvic floor muscles (PMFs) has been considered a major cause of stress urinary incontinence (SUI). In this way, the physiotherapeutic treatment, classically, turned to the strengthening of these muscles. In this study it was hypothesized that, in addition to PMFs weakness, this dysfunction may also be related to a change in the pattern of reflex response of these muscles. Objective: The study objectives were to compare the contraction response time and strength of cough-induced PMFs among continents and SUI women, and to conduct a literature review on the use of biofeedback for pelvic floor muscle training in women with this dysfunction. Methods: Study II: A systematic review was conducted with a search of the databases Science Direct, Embase, MEDLINE, Pedro, SciELO, CINAHL and LILACS for randomized clinical trials that had biofeedback (BF) as a therapeutic tool for SUI. Study II: This was a cross-sectional study that evaluated the cough PMFs of 20 healthy women and 20 women with SUI. The clinical evaluation consisted of the application of questionnaires that assessed the severity of urinary incontinence and quality of life. Signal capture was performed with a 4-channel acquisition system (EMG System do Brasil Ltda??) to capture the signals obtained through vaginal dynamometry, electromyography (EMG) of the right external obliquus muscle and accelerometry. Statistical analysis was performed using the Shapiro-Wilk, independent t test or Mann-Whitney test according to the data distribution and the covariance analysis (ANCOVA) with post hoc Bonferrone test. The statistical significance considered for all tests was p <0.05. Results: Study I: the training of the PMFs with BF was not better than the control group (without training and orientation, vaginal electrical stimulation). However, these contradictory results and poor quality of the studies are probably not clinically significant. Study II: the contraction response of the PMFs was significantly different between the groups for the activation time of the PMFs (F = 19.51, P <0.0001, ???p2= 0.61), external oblique muscle activation time (F = 11.41, P <0.002, ???p2= 0.23) and time of the cough pulse (F = 4.21, P <0.04, ???p2= 0.10). Conclusion: The systematic review provides evidence that the training of BF-PMFs does not offer superior therapeutic benefits to other types of interventions in the treatment of female SUI. The cross-sectional study showed that women with SUI have delayed cough-induced contraction of PMFs. |
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Politti, FabianoPolitti, FabianoCorrea, Fernanda IshidaBiasotto-Gonzalez, Daniela AparecidaAmorim, C??sar Ferreirahttp://lattes.cnpq.br/7249345739207327Nunes, Erica Feio Carneiro2018-07-20T20:10:21Z2018-03-06Nunes, Erica Feio Carneiro. An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o. 2018. 70 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.http://bibliotecatede.uninove.br/handle/tede/1891Contextualization: Weakening of pelvic floor muscles (PMFs) has been considered a major cause of stress urinary incontinence (SUI). In this way, the physiotherapeutic treatment, classically, turned to the strengthening of these muscles. In this study it was hypothesized that, in addition to PMFs weakness, this dysfunction may also be related to a change in the pattern of reflex response of these muscles. Objective: The study objectives were to compare the contraction response time and strength of cough-induced PMFs among continents and SUI women, and to conduct a literature review on the use of biofeedback for pelvic floor muscle training in women with this dysfunction. Methods: Study II: A systematic review was conducted with a search of the databases Science Direct, Embase, MEDLINE, Pedro, SciELO, CINAHL and LILACS for randomized clinical trials that had biofeedback (BF) as a therapeutic tool for SUI. Study II: This was a cross-sectional study that evaluated the cough PMFs of 20 healthy women and 20 women with SUI. The clinical evaluation consisted of the application of questionnaires that assessed the severity of urinary incontinence and quality of life. Signal capture was performed with a 4-channel acquisition system (EMG System do Brasil Ltda??) to capture the signals obtained through vaginal dynamometry, electromyography (EMG) of the right external obliquus muscle and accelerometry. Statistical analysis was performed using the Shapiro-Wilk, independent t test or Mann-Whitney test according to the data distribution and the covariance analysis (ANCOVA) with post hoc Bonferrone test. The statistical significance considered for all tests was p <0.05. Results: Study I: the training of the PMFs with BF was not better than the control group (without training and orientation, vaginal electrical stimulation). However, these contradictory results and poor quality of the studies are probably not clinically significant. Study II: the contraction response of the PMFs was significantly different between the groups for the activation time of the PMFs (F = 19.51, P <0.0001, ???p2= 0.61), external oblique muscle activation time (F = 11.41, P <0.002, ???p2= 0.23) and time of the cough pulse (F = 4.21, P <0.04, ???p2= 0.10). Conclusion: The systematic review provides evidence that the training of BF-PMFs does not offer superior therapeutic benefits to other types of interventions in the treatment of female SUI. The cross-sectional study showed that women with SUI have delayed cough-induced contraction of PMFs.Contextualiza????o: O enfraquecimento dos m??sculos do assoalho p??lvico (MAPs) tem sido considerada uma das principais causas da incontin??ncia urin??ria por esfor??o (IUE). Dessa maneira, o tratamento fisioterap??utico, classicamente, se voltou para o fortalecimento desses m??sculos. Nesse estudo foi hipotetizado que, al??m da fraqueza dos MAP, essa disfun????o tamb??m pode estar relacionada ?? uma altera????o no padr??o de resposta reflexa desses m??sculos. Objetivo: Os objetivos deste estudo foram comparar o tempo de resposta da contra????o e a for??a dos MAPs induzidos pela tosse entre mulheres continentes e com IUE e, realizar uma revis??o de literatura sobre o uso do biofeedback para treinamento muscular do assoalho p??lvico em mulheres com essa disfun????o. M??todos: Estudo I: Foi realizada uma revis??o sistem??tica com uma busca nas bases de dados Science Direct, Embase, MEDLINE, Pedro, SciELO, CINAHL e LILACS por ensaios clinicos randomizados que tivessem o biofeedback (BF) como instrumento terapeutico para a IUE. Estudo II: Esse foi um estudo transversal que avaliou os MAPs durante a tosse de 20 mulheres saud??veis e 20 mulheres com IUE. A avalia????o cl??nica consistiu na aplica????o dos question??rios que avaliaram a gravidade da incontin??ncia urin??ria e a qualidade de vida. A capta????o dos sinais foi realizada com um sistema de aquisi????o com 4 canais (EMG System do Brasil Ltda??) para captar os sinais obtidos por meio da dinamometria vaginal, da eletromiografia (EMG) do m??sculo obliquo externo direito e da acelerometria. Para an??lise estat??stica foram utilizados os testes de Shapiro-Wilk, t independente ou Mann-Whitney test de acordo com a distribui????o dos dados e a an??lise de covari??ncia (ANCOVA) com test post hoc de Bonferrone. A signific??ncia estat??stica considerada para todos os testes foi de p<0,05. Resultados: Estudo I: o treinamento dos MAPs com BF n??o foi melhor do que o grupo controle (sem treinamento e orienta????o, estimula????o el??trica vaginal). No entanto, estes resultados contradit??rios e a m?? qualidade dos estudos provavelmente n??o s??o clinicamente significativos. Estudo II: A resposta de contra????o dos MAPs foi significativamente diferente entre os grupos para o tempo de ativa????o dos MAPs (F=19.51, P <0.0001,???p2=0.61), Tempo de ativa????o do m??sculo obliquo externo (F=11.41, P < 0.002, ???p2=0.23) e tempo do pulso da tosse (F=4.21, P < 0.04, ???p2=0.10). Conclus??o: A revis??o sistem??tica fornece evid??ncias de que a treinamento dos MAPs com BF n??o oferece benef??cios terap??uticos superiores a outros tipos de interven????es no tratamento da IUE feminina. O estudo tranversal mostrou que mulheres com IUE apresentam atraso na resposta da contra????o dos MAPs induzidos pela tosse.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-20T20:10:21Z No. of bitstreams: 1 Erica Feio Carneiro Nunes.pdf: 1021018 bytes, checksum: 040c57768f7aed071b8aa73bd056ade6 (MD5)Made available in DSpace on 2018-07-20T20:10:21Z (GMT). No. of bitstreams: 1 Erica Feio Carneiro Nunes.pdf: 1021018 bytes, checksum: 040c57768f7aed071b8aa73bd056ade6 (MD5) Previous issue date: 2018-03-06application/pdfporUniversidade Nove de JulhoPrograma de P??s-Gradua????o em Ci??ncias da Reabilita????oUNINOVEBrasilSa??defisioterapiadinam??metria incontin??ncia urin??ria por esfor??om??sculos do assoalho p??lvicophysiotherapy, dynamometrystress urinary incontinencepelvic floor musclesCIENCIAS DA SAUDEAn??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??oAnalysis of the response time of contraction of the muscles of the pelvic floor produced by tosse between womem continent and with urinary incontinence of effortinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALErica Feio Carneiro Nunes.pdfErica Feio Carneiro Nunes.pdfapplication/pdf1021018http://localhost:8080/tede/bitstream/tede/1891/2/Erica+Feio+Carneiro+Nunes.pdf040c57768f7aed071b8aa73bd056ade6MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/1891/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/18912018-07-20 17:10:21.589oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2018-07-20T20:10:21Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false |
dc.title.por.fl_str_mv |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o |
dc.title.alternative.eng.fl_str_mv |
Analysis of the response time of contraction of the muscles of the pelvic floor produced by tosse between womem continent and with urinary incontinence of effort |
title |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o |
spellingShingle |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o Nunes, Erica Feio Carneiro fisioterapia dinam??metria incontin??ncia urin??ria por esfor??o m??sculos do assoalho p??lvico physiotherapy, dynamometry stress urinary incontinence pelvic floor muscles CIENCIAS DA SAUDE |
title_short |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o |
title_full |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o |
title_fullStr |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o |
title_full_unstemmed |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o |
title_sort |
An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o |
author |
Nunes, Erica Feio Carneiro |
author_facet |
Nunes, Erica Feio Carneiro |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Politti, Fabiano |
dc.contributor.referee1.fl_str_mv |
Politti, Fabiano |
dc.contributor.referee2.fl_str_mv |
Correa, Fernanda Ishida |
dc.contributor.referee3.fl_str_mv |
Biasotto-Gonzalez, Daniela Aparecida |
dc.contributor.referee4.fl_str_mv |
Amorim, C??sar Ferreira |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/7249345739207327 |
dc.contributor.author.fl_str_mv |
Nunes, Erica Feio Carneiro |
contributor_str_mv |
Politti, Fabiano Politti, Fabiano Correa, Fernanda Ishida Biasotto-Gonzalez, Daniela Aparecida Amorim, C??sar Ferreira |
dc.subject.por.fl_str_mv |
fisioterapia dinam??metria incontin??ncia urin??ria por esfor??o m??sculos do assoalho p??lvico |
topic |
fisioterapia dinam??metria incontin??ncia urin??ria por esfor??o m??sculos do assoalho p??lvico physiotherapy, dynamometry stress urinary incontinence pelvic floor muscles CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
physiotherapy, dynamometry stress urinary incontinence pelvic floor muscles |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Contextualization: Weakening of pelvic floor muscles (PMFs) has been considered a major cause of stress urinary incontinence (SUI). In this way, the physiotherapeutic treatment, classically, turned to the strengthening of these muscles. In this study it was hypothesized that, in addition to PMFs weakness, this dysfunction may also be related to a change in the pattern of reflex response of these muscles. Objective: The study objectives were to compare the contraction response time and strength of cough-induced PMFs among continents and SUI women, and to conduct a literature review on the use of biofeedback for pelvic floor muscle training in women with this dysfunction. Methods: Study II: A systematic review was conducted with a search of the databases Science Direct, Embase, MEDLINE, Pedro, SciELO, CINAHL and LILACS for randomized clinical trials that had biofeedback (BF) as a therapeutic tool for SUI. Study II: This was a cross-sectional study that evaluated the cough PMFs of 20 healthy women and 20 women with SUI. The clinical evaluation consisted of the application of questionnaires that assessed the severity of urinary incontinence and quality of life. Signal capture was performed with a 4-channel acquisition system (EMG System do Brasil Ltda??) to capture the signals obtained through vaginal dynamometry, electromyography (EMG) of the right external obliquus muscle and accelerometry. Statistical analysis was performed using the Shapiro-Wilk, independent t test or Mann-Whitney test according to the data distribution and the covariance analysis (ANCOVA) with post hoc Bonferrone test. The statistical significance considered for all tests was p <0.05. Results: Study I: the training of the PMFs with BF was not better than the control group (without training and orientation, vaginal electrical stimulation). However, these contradictory results and poor quality of the studies are probably not clinically significant. Study II: the contraction response of the PMFs was significantly different between the groups for the activation time of the PMFs (F = 19.51, P <0.0001, ???p2= 0.61), external oblique muscle activation time (F = 11.41, P <0.002, ???p2= 0.23) and time of the cough pulse (F = 4.21, P <0.04, ???p2= 0.10). Conclusion: The systematic review provides evidence that the training of BF-PMFs does not offer superior therapeutic benefits to other types of interventions in the treatment of female SUI. The cross-sectional study showed that women with SUI have delayed cough-induced contraction of PMFs. |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-07-20T20:10:21Z |
dc.date.issued.fl_str_mv |
2018-03-06 |
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dc.identifier.citation.fl_str_mv |
Nunes, Erica Feio Carneiro. An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o. 2018. 70 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo. |
dc.identifier.uri.fl_str_mv |
http://bibliotecatede.uninove.br/handle/tede/1891 |
identifier_str_mv |
Nunes, Erica Feio Carneiro. An??lise do tempo de resposta de contra????o dos m??sculos do assoalho p??lvico provocado pela tosse entre mulheres continentes e com incontin??ncia urin??ria de esfor??o. 2018. 70 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo. |
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http://bibliotecatede.uninove.br/handle/tede/1891 |
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UNINOVE |
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Brasil |
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Universidade Nove de Julho |
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