BACKGROUND: Self-efficacy has been shown to be a predictor of many health-related behaviors, including the practice of pelvic floor exercises with a focus on prevention or cure. OBJECTIVES: To describe the process of construction and the psychometric properties of the scale of self-efficacy for the practice of pelvic floor exercises (EAPEAP). METHOD: A cross-sectional study of validation was carried out with 81 from community and 96 postpartum women, 54.8% of them complained of urinary leakage. An exploratory factor analysis and internal consistency analysis was performed. To check predictive capacity, we analyzed the adherence at 3 months post - intervention and compared the scores of self-efficacy between adherent and non-adherent women. Reliability was analyzed by split half procedure. RESULTS: The instrument showed α=0.923, and revealed three factors: performance expectation considering the action, performance expectation considering the preparation for action and outcome expectations. These factors accounted for 65.32% of the total variance. The instrument was able to differentiate between women who adhere and have not adhered to the exercises (U=352, p=0.013) and there was strong correlation between the two halves of the instrument (rho=0.889, p<0.001). CONCLUSION: The scale is a valid and reliable tool to measure self-efficacy to practice pelvic floor exercises.

/pdf/the-development-and-psychometric-evaluation-of-a-self-3wte341tav.pdf

The development and psychometric evaluation of a self-efficacy scale for practicing pelvic floor exercises

Purpose: To determine if weight training combined with pelvic floor muscle training is more efficient than pelvic floor muscle training alone for the treatment of urinary incontinence (UI) symptoms...

Effect of Weight Training with Pelvic Floor Muscle Training in Elderly Women with Urinary Incontinence

Who Will Benefit From Pelvic Floor Muscle Training for Stress Urinary Incontinence

OBJETIVOS: analizar la Fuerza Muscular del Suelo Pelvico (FMSP) de embarazadas con uno o mas partos normales o cesareas; comparar la FMSP de estas embarazadas con la FMSP de primigestas.METODO: estudio transversal con embarazadas hasta 12 semanas de embarazo, realizado en Itapecerica de la Serra, SP, de diciembre de 2012 a mayo de 2013. La muestra fue de 110 embarazadas con uno o mas partos normales o cesareas y 110 primigestas. La FMSP fue evaluada por la perineometria (Peritron(tm)) y palpacion digital vaginal (escala de Oxford modificada).RESULTADOS: el promedio de la FMSP en embarazadas con antecedentes de parto normal o cesarea fue 33,4 (de=21,2) cmH2O. Por la escala de Oxford, 75,4% de las embarazadas con partos o cesareas anteriores presentaron grado ≤ 2 y 5,5%, grado ≥ 4; entre las primigestas, 39,9% presentaron grado ≤ 2 y 50,9%, grado ≥ 4, con diferencia estadisticamente significativa (p<0,001). Por la perineometria, no hubo diferencia estadisticamente significativa entre la FMSP y edad, tipo de parto, numero de partos anteriores, indice de masa corporal y sintomas del tracto genitourinario, pero hubo entre las embarazadas con y sin antecedente de episiotomia (p=0,04). En la palpacion, ninguna de las variables mostro diferencia estadisticamente significativa.CONCLUSION: el embarazo y el parto pueden reducir la FMSP.

Evaluation of perineal muscle strength in the first trimester of pregnancy.

PURPOSE: To evaluate the effectiveness of an illustrated home exercise guide targeting the pelvic floor muscles in promoting urinary continence during pregnancy.METHODS: A randomized clinical trial was performed with 87 participants, evaluated six times during pregnancy and divided into three groups: Gsup, supervised; Gobs, not supervised, and Gref, women who did not perform the home exercises program. A miction diary and perineometry were used to evaluate urinary incontinence (primary outcome) and pelvic floor muscle strength (secondary outcome), respectively. The Kruskal-Wallis test with post hoc Dunn's and chi-square and Z tests with Bonferroni correction were used for continuous variables and proportions, respectively, with the level of significance set at 5%.RESULTS: At the end of the study, 6.9% of pregnant women in the Gsup and Gobs had urinary incontinence, while 96.6% of Gref women were incontinent. Regarding pelvic floor muscle function, Gsup and Gobs had mean contractions of 10 and 8.9 cmH2O, respectively, while Gref had a value of 4.7 cmH2O. Both results were significant.CONCLUSION: An illustrated home exercise guide targeting the pelvic floor muscles is effective in promoting urinary continence during pregnancy, even without permanent supervision.

/pdf/effectiveness-of-an-illustrated-home-exercise-guide-on-5anmbg2xfx.pdf

Effectiveness of an illustrated home exercise guide on promoting urinary continence during pregnancy: a pragmatic randomized clinical trial

OBJETIVOS: Descrever os resultados da pratica de exercicios domicilares para o assoalho pelvico em mulheres continentes nos quesitos avaliacao funcional do assoalho pelvico (AFA) e presenca de incontinencia urinaria apos um ano de tratamento fisioterapeutico. METODOS: Estudo observacional com 15 mulheres um ano apos o tratamento fisioterapeutico para incontinencia urinaria de esforco (IUE). As variaveis analisadas neste estudo foram: situacoes de perda urinaria, utilizacao de protecao diaria, manutencao dos exercicios domiciliares para o assoalho pelvico, AFA e satisfacao da paciente em relacao ao tratamento. Tambem foram investigadas algumas variaveis de confusao, como: estado hormonal, numero de partos vaginais e realizacao de episiotomia. RESULTADOS: Apos um ano do termino do tratamento fisioterapeutico, observou-se que a AFA manteve-se (Md=5; p=0,08). Quanto a presenca de perda urinaria, 40% da amostra relatou ser leve, nao sendo necessaria a utilizacao de protetores diarios. Observou-se tambem associacao significante (p=0,001) entre a pratica de exercicios domiciliares e o quadro clinico normal. As variaveis de confusao, que poderiam comprometer o quadro clinico, nao apresentaram associacao significativa (p≥0,05). CONCLUSAO: A realizacao dos exercicios domiciliares sugeridos demonstra ser uma variavel importante na manutencao da continencia urinaria ao final do tratamento fisioterapeutico.

/pdf/home-exercises-for-pelvic-floor-in-continent-women-one-year-3os5au97sw.pdf

Home exercises for pelvic floor in continent women one year after physical therapy treatment for urinary incontinence: an observational study

Objectives: To describe the results of home exercise targeting the pelvic floor in continent women one year after the end of a physical therapy treatment for the following outcomes: functional assessment of the pelvic floor and urinary incontinence. Methods: This is an observational study that evaluated fifteen women one year after physical therapy treatment for Stress Urinary Incontinence (SUI). The outcomes for this study were: situations of urinary loss, use of daily protection, practice of home exercises for the pelvic floor, functional assessment of the pelvic floor (FAPF) and patient satisfaction. We also investigated some confounding variables such as hormonal status, number of vaginal deliveries and previous history of episiotomy. Results: One year after completion of physical therapy treatment, we observed that the FAPF median remained stable over time (Median=5, p=0.08). The presence of urinary incontinence was reported by 40% of women in the sample, however, was characterized as mild (i.e. not requiring the use of daily protection). There was also a significant association (p=0.001) between the completion of home exercises (twice or more per week) and the normal clinical status. Confounding variables, which could compromise the clinical status, showed no significant association with the outcomes (p ≥0.05). Conclusion: Home exercises contributed to the maintenance of continence following a physical therapy treatment.

/pdf/home-exercises-for-pelvic-floor-in-continent-women-one-year-28hb08o6r1.pdf

Home exercises for pelvic floor in continent women one year after physical therapy treatment for urinary incontinence: an observational study Exercício domicilar para o assoalho pélvico em mulheres continentes após tratamento fisioterapêutico para incontinência urinária: um estudo observacional

Soraia C. T. Luz

Papers

Home exercises for pelvic floor in continent women one year after physical therapy treatment for urinary incontinence: an observational study