Efeitos de um programa individualizado e supervisionado de exercícios para os músculos do assoalho pélvico em multíparas de parto vaginal

• Autor(a) principal: ASSIS, Thaís Rocha
• Data de Publicação: 2012
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tde/1532
• topic: Modalidades de fisioterapia; Força muscular; Assoalho pélvico; Período pós-parto; Comportamento sexual; Atenção primária à saúde; Fisioterapia assoalho pélvico; Fisiot força muscular períod pós-parto; Physical therapy modalities; Muscle strength; Pelvic floor, Postpartum period; Sexual behavior; Primary health care; CNPQ::CIENCIAS DA SAUDE

This study consists of two scientific papers. The first aimed at investigating the effects of an individualized and supervised exercise program to strengthen pelvic floor muscles (PFM) in the postpartum period of multiparous women, and verify the correlation between two methods used to assess muscle strength. The second paper aimed at verifying the perception that puerperal women have regarding the alterations to their vaginal area and sex life after childbirth and after a PFM exercise program. To achieve these goals, an open clinical trial was performed on the first study, while the second conducted an exploratory and descriptive study. The final sample consisted of 23 puerperal women divided into two groups: intervention group (IG, n=11) and control group (CG, n=12). In IG, the puerperal women participated in an eight-week PFM exercise program, twice a week. In CG, the puerperal women did not receive any recommendations regarding exercises. PFM strength was assessed by digital vaginal palpation using the modified Oxford Scale and perineometer. The statistical analysis of the first article was performed using the following tests: Fisher s Exact Test, Chi-squared Test, Student s t-test, Kolmogorov Smirnov test for the two samples, and Pearson s Correlation Coefficient. Significance was defined as p < 0.05. On the second paper, categories were established and content analysis was performed. The participants mean age in IG was 24 ± 4.56 years, and 25.33 ± 4.03 years in CG (p=0.465). By completing the PFM exercise program, a significant difference was observed between the groups in the two muscle strength assessments (p&#61500;0.001). The two methods used to assess muscular strength showed significant correlation in both assessments (1st assessment: r = 0.889 with p <0.001; 2nd assessment: r = 0.925 with p <0.001). In terms of the participants perception regarding any vaginal alteration in the late postpartum period, the most frequent reports in both groups were those related to the category perception of low vaginal tonus . Fourteen weeks into the postpartum period, at the end of the exercise program, the participants in IG presented more reports in the category perception of increased vaginal tonus and greater control over the PFM and those in the CG, in the category feels that the vagina is back in the same condition as before pregnancy . Finally, the exercise program resulted in a significant increase in PFM strength in puerperal women and showed positive effects on the perineal area and in the sex life of the participants. Good correlation was observed between digital vaginal palpation and perineometer, which indicates that vaginal palpation can be used in clinical practice, considering it is an inexpensive method that demonstrated significant correlation with an objective method, i.e. perineometer.