Impacto dos exercícios hipopressivos na função muscular do assoalho pélvico e nos sintomas urinários de mulheres com incontinência urinária de esforço: ensaio clínico randomizado controlado

• Autor(a) principal: Costa, Thais Fonseca [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6834627; https://repositorio.unifesp.br/handle/11600/52677
• topic: Pelvic floor; Hypopressive exercises; Rehabilitation; Assoalho pélvico; Exercicios hipopressivos; Reabilitação

Objective: To evaluate and compare the activation of pelvic floor muscles (MAP) during the exercise of Gynastic Abdominal Hypopressive (GAH) and pelvic floor muscle training (TMAP) by means of surface electromyography (EMG) after three months of training. Methods: Twentysix women with stress urinary incontinence (SUI) were included. Patients were randomized to the GAH (n = 16) or TMAP (n = 15) groups. Primary outcome measures: Evaluate the surface EMG activity of the MAP (during the execution of the GAH and TMAP technique after three months of training). Secondary outcome measures: Objective cure of SUI at the threemonth followup (assessed by pad test <2g); mean of weekly episodes of urinary loss (by 7day voiding diary); function of the pelvic floor muscles (MAP) (by the Oxford and Perfect scale); evaluation of the Maximum Voluntary Contraction (CVM) (by surface EMG after three months); quality of life through the Incontinence Quality of Life Questionnaire (IQoL) ; Check the adherence to the home exercises in the three months of treatment. Evaluations were performed at baseline and after three months of treatment. Statistical analysis: ANOVA and Student's t test with 5% cut for significance. Results: The TMAP group presented significantly greater muscle activation, measured by the EMG, during the execution of the exercise when compared to the GAH group. Both groups presented the same objective cure and decrease of SUI severity (by pad test and sevenday voiding diary). Both groups presented similar improvement of the muscular function in the measures of Oxford, Endurance, Repetition and Fast; and when the groups were compared, the TMAP group presented better function in Oxford, Endurance and Repetition. In the CVM evaluation after three months of treatment, only the TMAP group presented better EMG activation of the MAPs. In relation to the improvement in the quality of life, evaluated by IQOL, when comparing the groups, there was no difference. In the evaluation of adherence to the home exercises, the TMAP group showed a better adherence only in the first month. Conclusions: Both GAH and TMAP had a positive impact on pelvic floor muscle function and urinary incontinence. GAH was not superior to TMAP, and it is possible that new studies with a larger sample size may find different results.