DOCSLIB.ORG

From Kegel Exercises to Pelvic Floor Rehabilitation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
From Kegel Exercises to Pelvic Floor Rehabilitation ARTÍCULO DE REVISIÓN Rev Mex Urol. 2018 septiembre-octubre;78(5):402-411. From Kegel exercises to pelvic floor rehabilitation: A physiotherapeutic perspective De los ejercicios de Kegel a la rehabilitación del piso pélvico: una visión a partir de la fisioterapia María Cristina Rodas,1 Herney Andrés García-Perdomo2 1 Abstract PT, Pelvic Floor Physical Therapist, Pro- fessor, Universidad del Valle, Colombia. 2 Different pelvic floor therapy strategies have been adopted by physicians, urologists, MD MSc EdD PhD FACS Associate Pro- gynecologists, and physiotherapists. However, the concept of pelvic floor physiotherapy fessor, Universidad del Valle, Colombia. is not yet clear for the majority of professionals, who continue to suggest activities that can actually be more harmful to the patient than beneficial. Consequently, the aim of Recibido: agosto 2018 this review article was to present the concept of pelvic floor physiotherapy, from its Aceptado: septiembre 2018 origins to its current principles, so that healthcare professionals can apply the therapy to their patients based on a clear understanding of the approach. Correspondencia KEYWORDS: Pelvic floor therapy; Physiotherapy. Herney Garcia Perdomo [email protected] Resumen Twitter: @herneygarcia La terapia del piso pélvico se ha indicado con diferentes estrategias, adoptadas por Este artículo debe citarse como los médicos, urólogos, ginecólogos y fisioterapeutas. Sin embargo, el concepto de Rodas MC, García-Perdomo HA. From fisioterapia del piso pélvico aún no es claro para la mayoría de los profesionales, pues Kegel exercises to pelvic floor re- algunos protocolos sugieren actividades que pueden generar más daños que benefi- habilitation: A physiotherapeutic cios. En consecuencia, este artículo expone el concepto, desde sus orígenes hasta los perspective. Rev Mex Urol. 2018 sept- principios actuales, que todos los profesionales deben conocer y, por lo tanto, aplicar oct;78(5):402-411. en sus pacientes. DOI: https://doi.org/10.24245/rev- PALABRAS CLAVE: Piso pélvico; fisioterapia. mexurol.v78i5.2472 INTRODUCTION constipation, high-impact sports, or profes- sional activities, among others. As a result, the The pelvic floor is a set of structures, muscles, so-called pelvic floor dysfunctions can occur, and connective tissues that provides the pelvic which include (but are not limited to) urinary organs, such as the bladder, vagina, uterus, incontinence, fecal incontinence, sexual prob- and rectum, with stability and support. It may lems, pelvic pain, and genital prolapse. In the late more frequently be affected or weakened in 1940s, the gynecologist Arnold Kegel introduced women by the factors of pregnancy, childbirth, pelvic floor exercises for women who presented and menopause, or by poor micturition habits, with urinary incontinence. That approach pro- 402 www.revistamexicanadeurologia.org.mx Rodas MC et al. From Kegel exercises to pelvic floor rehabilitation duced progressive contraction of the levator The reading varied, according to the position in ani under strict supervision and introduced the which it was performed. Most important was the concept of biofeedback, as well.1-3 correct performance of the levator ani, without including the abdominal or gluteal muscles. Pa- Pelvic physiotherapy has currently undergone tients were given directions on how to carefully exponential development and plays an impor- perform the exercises,2 as well as how to over- tant role in the treatment of such disorders in come that contraction, and even how to increase men, women, and children.4 Pelvic floor muscle its frequency for periods of 20 minutes, three training, biofeedback, electrotherapy, vaginal times/day, reaching five contractions every 30 cones, hypopressive abdominal techniques, minutes.1,3 Dr. Kegel and his wife manufactured and urotherapy are among the physiothera- the necessary equipment in their kitchen and it peutic methods that specifically pertain to the was marketed in that fashion for approximately 5 pelvic floor. The comprehensive treatment of 30 years and up to three years after Dr. Kegel’s lumbopelvic problems and those of the peri- death. The exercises are a simple method that neal complex has demonstrated good results, can help improve the tone and function of that improving the self-esteem and quality of life of musculature.3,10 patients.6 The aim of the present review was to describe the current developments that the Kegel The Kegel article described how the patients exercises have brought to pelvic floor therapy. were instructed to perform pubococcygeus muscle contractions. The first step consisted of Kegel exercises recognizing the anatomic structures (the first Kegel exercise). The second step consisted of In 1948, as a professor of obstetrics and gynecol- gentle digital exploration to verify the contrac- ogy in the United States, Dr. Arnold Kegel was the tion and tone of the pubococcygeus muscle and first to propose training of the pelvic floor muscles other structures, and thus determine whether through a series of regularly repeated exercises. the patient knew those muscles had contracted. Their effectiveness was demonstrated in a paper Finally, the third step was to assess whether that titled Progressive resistance exercise in the func- 1 tional restoration of the perineal muscles.7,8 In that muscle contraction was learned. study, 64 patients received treatment for managing pelvic dysfunctions, as well as stress urinary in- In the 1960s and early 1970s, the management 11 continence (SUI) and immediate postpartum and indicated for urinary incontinence was surgical. genital prolapse (cystocele and rectocele-older The recommended first-line treatment, with no nomenclature). adverse effects, was the training of the pelvic floor muscles, but learning how to contract them In the context of the Kegel study, the levator ani is correctly was not easy, and the verbal or written a striated muscle, consisting of 67% slow-twitch directions proved to be insufficient, as Kegel fibers and 33% fast-twitch fibers, and its function had found in 40% of the patients.12 To facilitate is to squeeze around the openings of the anus, learning how to perform the exercises, the patient vagina, and urethra. Its contraction is not visible was instructed to imagine preventing the exit and is performed in a cephalad direction.9 The of fecal matter or urine flow. In 50% of cases, first biofeedback process was designed by Kegel, that contraction was performed using accessory using a rubber electrode of approximately 3.5 muscles of the abdomen or the gluteus, and in inches. It recorded a pressure of 0-100 mmHg. many cases worsened the symptoms.10 403 Revista Mexicana de UROLOGÍA 2018 septiembre-octubre;78(5) In his original publication in 1950, Kegel stated Bourcier disclosed those perineal re-education that the difference in contraction-relaxation of techniques for treating urinary incontinence in the pubococcygeus was 40 mmHg. Two years lat- written press and audiovisual media, and was er, in 1952, he showed that the difference was 20 recognized as a great promoter of perineal re- mmHg, which was more realistic.2 Subsequent education.14 Since then, different professionals studies reported that the pressure of the vagina, have been interested in the pathophysiologic, ep- in a healthy woman, was 25 mmHg and could idemiologic, preventive, and therapeutic aspects reach 45 mmHg with a voluntary muscle con- of pelvic floor dysfunctions, leading to the devel- traction. Unfortunately, no further publications opment of conservative noninvasive therapy for were published regarding the perineometer.2 the clinical conditions of incontinence, genital prolapse, neurologic lesions, sexual dysfunction, Subsequently, a group of medical specialists and anorectal canal dysfunction in men, women, found that the contraction of those muscles was and children.15 related to orgasmic capacity, as discussed in studies by Kline-Graber and Graber (1978), and In 1992, the International Continence Society later by Masters and Johnson (1966). Finally, in (ICS) validated employing those techniques 1972, Hartman and Fithian introduced the use of for the treatment of perineal disorders and the the perineometer as a tool that could assist in the functional recovery of the pelvic floor.14 The treatment of sexual dysfunction, in accordance techniques are evidence-based, which aids the with the study by Kegel, Masters, and Johnson.2 physiotherapist in developing a treatment plan based on clinical research. Several studies have Physical therapy as support for the pelvic floor shown the interventions to be effective in the management of SUI, but there is still insufficient Within the management of pelvic floor dysfunc- evidence in relation to other dysfunctions.13 tion, the physiotherapist plays a very important role in prevention and treatment. His or her posi- The pelvic physiotherapist evaluates the patient tion is to inform patients about the dysfunction and establishes a physiotherapeutic diagnosis, and changes in lifestyle and to employ physio- which enables a protocol and a non-invasive therapeutic resources. They include technical treatment modality to be organized. The first step manuals and the training of the pelvic floor is to educate the patients, to establish a strategy, muscles with the help of biofeedback, electrical and to formulate a preventive program and a stimulation, and vaginal cones, among other supplemental protocol that provide positive techniques. The educational approach facilitates
Load more

Recommended publications
  • Urinary Incontinence: Impact on Long Term Care
    Urinary Incontinence: Impact on Long Term Care Muhammad S. Choudhury, MD, FACS Professor and Chairman Department of Urology New York Medical College Director of Urology Westchester Medical Center 1 Urinary Incontinence: Overview • Definition • Scope • Anatomy and Physiology of Micturition • Types • Diagnosis • Management • Impact on Long Term Care 2 Urinary Incontinence: Definition • Involuntary leakage of urine which is personally and socially unacceptable to an individual. • It is a multifactorial syndrome caused by a combination of: • Genito urinary pathology. • Age related changes. • Comorbid conditions that impair normal micturition. • Loss of functional ability to toilet oneself. 3 Urinary Incontinence: Scope • Prevalence of Urinary incontinence increase with age. • Affects more women than men (2:1) up to age 80. • After age 80, both women and men are equally affected. • Urinary Incontinence affect 15% to 30% of the general population > 65 years. • > 50% of 1.5 million Long Term Care residents may be incontinent. • The cost to care for this group is >5 billion per year. • The total cost of care for Urinary Incontinence in the U.S. is estimated to be over $36 billion. Ehtman et al., 2012. 4 Urinary Incontinence: Impact on Quality of Life • Loss of self esteem. • Avoidance of social activity and interaction. • Decreased ability to maintain independent life style. • Increased dependence on care givers. • One of the most common reason for long term care placement. Grindley et al. Age Aging. 1998; 22: 82-89/Harris T. Aging in the eighties. NCHS # 121 1985. Noelker L. Gerontologist 1987; 27: 194-200. 5 Health related consequences of Urinary Incontinence • Increased propensity for fall/fracture.
    [Show full text]
  • Kegels: Female Pelvic Floor Exercises What Are Kegel Exercises? Kegel Exercises Strengthen the Pelvic Floor Muscles
    Kegels: Female Pelvic Floor Exercises What are Kegel exercises? Kegel exercises strengthen the pelvic floor muscles. These muscles support the bladder and bowel openings. Strengthening the muscles of the pelvic floor can aid in preventing leakage of urine or feces when you cough, sneeze, lift, or do other stressful movements. Other benefits of Kegels include: Enhanced sexual function Conditioned muscles to make childbirth easier Decreased or prevention of prolapsed pelvic organs Improved ability to pass stool © NIDDK Who should do Kegel exercises? Women with urinary and /or bowel incontinence Women who have demonstrated weakening of the pelvic floor Pregnant women or women who have previously had children Middle aged and older women Physical Medicine and Rehabilitation - 1 - What do I need to know about Kegels? Your success while doing Kegel exercises depends on you practicing them correctly and regularly. When doing the exercises, it is important to identify the correct muscles of the pelvic floor. At first, most people contract the abdominal or thigh muscles while forgetting the pelvic floor muscles. This could make pelvic floor tone and incontinence worse. If you are not sure that you are doing the Kegel exercise correctly, ask your doctor to refer you to a Pelvic Floor Physical Therapist (PT). The PT will evaluate you and provide specific instructions on how to do the exercises. “Kegel exercises diagram" by Gend27 - Own work. Licensed under CC BY-SA 3.0 via Commons You may do Kegels as part of biofeedback. Biofeedback consists of placing a sensor on the abdomen and around the anal area, which measures the tightening of the pelvic floor muscles.
    [Show full text]
  • Original Article Effects of Kegel Exercises Applied to Urinary Incontinence on Sexual Satisfaction
    Int J Clin Exp Med 2016;9(6):12365-12374 www.ijcem.com /ISSN:1940-5901/IJCEM0021587 Original Article Effects of kegel exercises applied to urinary ıncontinence on sexual satisfaction Şenay Topuz1*, Emine Ü Seviğ2* 1Department of Midwifery, Health Science Faculty, Ankara University, Ankara, Turkey; 2Department of Public Health Nursing, Health Science Faculty, Erciyes University, Kayseri, Turkey. *Equal contributors. Received December 10, 2015; Accepted March 19, 2016; Epub June 15, 2016; Published June 30, 2016 Abstract: This study is a semi-experimental study in order to explore the effect of Kegel exercises upon sexual sat- isfaction among the women who suffered from urinary incontinence. The sample of the study is consisted of 30 women who are diagnosed with urinary incontinence. Illustrative data form, GRISS were initially applied to women, kegel exercises were taught to women by the researcher and after 3 months of application were filled with scales. All of the women who were studied are at least primary school graduate and are married. Before the application it was seen that the women had problems in GRISS satisfaction, touch, vaginismus and anorgasmia sub groups. Yet, after the application its seen that the sexual satisfaction raised in these sub groups except vaginismus. A very important positive change was experienced in satisfaction and anorgasmia. A rise in sexual satisfaction was also detected after the application on thickness and avoidance sub groups and on total points. As a result of the study, it was detected that kegel exercises had positive effect on womens sexual satisfaction. However, performing of long term and broader sample studies shouldbe offered.
    [Show full text]
  • Preoperative Exercise Interventions to Optimize Continence Outcomes Following Radical Prostatectomy
    REVIEWS Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy Sean F. Mungovan 1,2,3 ✉ , Sigrid V. Carlsson4,5,6, Gregory C. Gass2,7, Petra L. Graham 8, Jaspreet S. Sandhu4, Oguz Akin 9, Peter T. Scardino4, James A. Eastham4 and Manish I. Patel 10,11 Abstract | Urinary incontinence is a common and predictable consequence among men with localized prostate cancer who have undergone radical prostatectomy. Despite advances in the surgical technique, urinary continence recovery time remains variable. A range of surgical and patient- related risk factors contributing to urinary incontinence after radical prostatectomy have been described, including age, BMI, membranous urethral length and urethral sphincter insufficiency. Physical activity interventions incorporating aerobic exercise, resistance training and pelvic floor muscle training programmes can positively influence the return to continence in men after radical prostatectomy. Traditional approaches to improving urinary continence after radical prostatectomy have typically focused on interventions delivered during the postoperative period (rehabilitation). However, the limited efficacy of these postoperative approaches has led to a shift from the traditional reactive model of care to more comprehensive interventions incorporating exercise- based programmes that begin in the preoperative period (prehabilitation) and continue after surgery. Comprehensive prehabilitation interventions include appropriately prescribed aerobic exercise, resistance
    [Show full text]
  • Kegel Exercises2
    KEGEL EXERCISES A Kegel exercise, named after Dr. Arnold Kegel, consists of contracting and relaxing the muscles that form part of thepelvic floor (which some people now colloquially call the "Kegel muscles"). The aim of Kegel exercises is to improve muscle tone by strengthening the pubococcygeus muscles of the pelvic floor. Advantages of Kegel eercises are : Kegel is a popular prescribed exercise for pregnant women to prepare the pelvic floor for physiological stresses of the later stages of pregnancy and vaginal childbirth. Kegel exercises are said to be good for treating vaginal prolapse and preventing uterine prolapse in women . In men they say these are useful for treating prostate pain and swelling resulting from benign prostatic hyperplasia(BPH) and prostatitis in men. Kegel exercises may be beneficial in treating urinary incontinence in both men and women. Kegel exercises may also increase sexual gratification. Sexual function Kegel workouts can provide men with stronger erections. Research published in 2005 issue of BJU International, have shown that pelvic floor exercises could help restore erectile function in men with erectile disfunction. There are said to be significant benefits for the problem of premature ejaculation from having more muscular control of the pelvis.It is also possible that strengthening the pelvic floor may allow some men to achieve a form of orgasmwithout allowing ejaculation, and thereby perhaps reach multiple "climaxes" during sexual activity. In men, this exercise lifts up the testicles, also strengthening the cremaster muscle, as well as the anal sphincter, as the anus is the main area contracted when a Kegel is done.
    [Show full text]
  • The Effect of Pelvic Floor (Kegel) Exercises on Sexual Satisfaction of 20-40-Year-Old Women Referring to Women′S Counseling Center in 2015: Rafsanjan Health Center No
    Focus on Sciences Original Article Feb 2018, Volume 4, Issue 1 The Effect of Pelvic Floor (Kegel) Exercises on Sexual Satisfaction of 20-40-Year-old Women Referring to Women′s Counseling Center in 2015: Rafsanjan Health Center No. 1 Mohammadreza Mirzabeigi 1, Batoul Shafiei Marji 2,*, Mohammadreza Mokhtaree 3 1 Assistant Professor, Psychiatry Department, Rafsanjan University of Medical Sciences, Rafsanjan, Iran 2 MSc, Department of General Psychology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran 3 MSc, Department of Educational Psychology, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran * Corresponding author: Batoul Shafiei Marji, MSc, Department of General Psychol- ogy, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. E-mail: bty.shafie@ yahoo.com Submitted: 12.13.2017 Abstract Accepted: 04.04.2018 Introduction: Sexual disorders are common among women. This study aimed to investigate the effect of pelvic exercises on women›s sexual satisfaction. Keywords: Methods: Fifty subjects among 20-40-year-old women referring to the counseling center Orgasm No. 1 of Rafsanjan Health Department were selected using convenient sampling and Pelvic Floor Exercises randomly divided into two experimental and control groups. The participants completed Kegel Linda Berg›s Sexual Satisfaction Scale in pretest and posttests. Five training sessions were © 2018. Focus on Sciences held on pelvic muscle (Kegel) exercises for the experimental group. The control group received no training.The collected data were analyzed using independent t-test, chi-square test and covariance analysis. Results: Sexual satisfaction did not differ between the two groups in pretest (P = 0.614). No high rate of sexual satisfaction was observed for both groups in the pre-test; however, the difference was significant between the pre- and post-test sexual satisfaction scores for the experimental group (P = 0.02).
    [Show full text]
  • The Effect of Pelvic Floor Muscle Training on Incontinence
    JMHXXX10.1177/1557988318757242American Journal of Men’s HealthAydın Sayılan and Özbaş 757242research-article2018 Original Article American Journal of Men’s Health 2018, Vol. 12(4) 1007 –1015 The Effect of Pelvic Floor Muscle © The Author(s) 2018 Reprints and permissions: sagepub.com/journalsPermissions.nav Training On Incontinence Problems DOI:https://doi.org/10.1177/1557988318757242 10.1177/1557988318757242 After Radical Prostatectomy journals.sagepub.com/home/jmh Aylin Aydın Sayılan1 and Ayfer Özbaş2 Abstract The aim of the current study was to determine the effect of pelvic floor muscle exercises (PFME/Kegel) training administered to patients scheduled for robot-assisted radical prostatectomy on postprocedural incontinence problems. This study was a randomized controlled trial. Pelvic floor muscle exercises were applied to the procedure group three times a day for 6 months. No exercises were applied to the control group. Incontinence and quality-of-life assessments of the 60 patients in the experimental and control groups were performed on months 0 (10 days after removal of the urinary catheter), 1, 3, and 6 through face-to-face and telephone interviews. Total Incontinence Consultation on Incontinence-Short Form scores, which provide an objective criterion for the evaluation of individuals with incontinence problems, decreased over time. This decrease was statistically highly significant in the third and sixth months. Pelvic muscle floor exercises are suitable for patients experiencing incontinence after radical prostatectomy. Keywords urinary incontinence, prostatectomy, muscle stretching exercises. Received October 8, 2017; revised December 19, 2017; accepted January 3, 2018 Prostate cancer is one of the most common cancer types therefore involves noninvasive behavioral therapeutic in men, and the prevalence increases with age (Vidmar methods consisting of diet modification, bladder train- et al., 2017).
    [Show full text]
  • Pelvic Floor Muscle Exercise with Biofeedback Helps Regain Urinary
    Original article eISSN 2384-0293 Yeungnam Univ J Med 2021;38(1):39-46 https://doi.org/10.12701/yujm.2020.00276 Pelvic floor muscle exercise with biofeedback helps regain urinary continence after robot-assisted radical prostatectomy Yeong Uk Kim1, Dong Gyu Lee2, Young Hwii Ko3 1Department of Urology, Yeungnam Hospital, of Medicine, Daegu, Korea 2Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea 3Department of Urology, Yeungnam University College of Medicine, Daegu, Korea Received: April 12, 2020 Revised: May 5, 2020 Background: To determine the benefit of pelvic floor muscle exercise (PFME) with visual biofeed- Accepted: May 7, 2020 back on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatec- Corresponding author: tomy (RARP). Young Hwii Ko Methods: Of the 83 patients enrolled, 41 consecutive patients completed PFME (the exercise Department of Urology, Yeungnam group), and the other 42 consecutive patients just before the PFME program commenced (the University College of Medicine, 170 control group). The primary outcome was whether PFME engagement was associated with zero Hyeonchung-ro, Namgu, Daegu pad continence restoration within 3 months of surgery. 42415, Korea Results: Continence restoration percentages (defined as zero pads used per day) at 1, 3, and 6 Tel: +82-53-620-3694 Fax: +82-53-627-5535 months after surgery were 49.4%, 77.1%, and 94.0%, respectively. The exercise group achieved E-mail: [email protected] significantly higher recovery rates at 1 month (p=0.037), 3 months (p<0.001), and 6 months (p=023).
    [Show full text]
  • Radical Prostatectomy - a Patient Guide
    Your Health Matters Radical Prostatectomy - A Patient Guide UCSF Urology Program Peter R. Carroll, MD, MPH, Matthew Cooperberg, MD, MPH, and UCSF Patient Advocates Department of Urology UCSF Helen Diller Family Comprehensive Cancer Center University of California, San Francisco 550 16th Street Box 1695 San Francisco, CA 94143 For appointments, please telephone 415-353-7171 Your Feedback: We regularly revise this information to keep it up to date and make it as useful as possible to the reader. Because changes and new developments can occur frequently, we suggest you talk to your provider for the latest information. Your feedback about any aspect of this document would be much appreciated. You can e-mail your comments to [email protected]. If you wish to talk with a patient advocate, please call (415) 885-7210. This guide, along with other urologic oncology documents, can be viewed online with this link: http://urology.ucsf.edu/patient-care/cancer/prostate- cancer If you are reading a hard copy, please also refer to the above link for the most up to date information. Words that appear in italics are described in the glossary at the end of this document. Overview A radical prostatectomy is a surgical procedure where the prostate gland is removed. At UCSF we perform laparoscopic radical prostatectomies using a robotic surgical system called the da Vinci® robot. Lymph nodes near the prostate can be removed at the same time. Radical prostatectomy is one option for men with clinically localized prostate cancer. Potential advantages include the following: 1) Removal of the prostate and analysis by a pathologist which allows accurate assessment of cancer aggressiveness (stage and grade); 2) After surgery the serum PSA (prostate specific antigen) level should be undetectable, but monitored regularly.
    [Show full text]
  • Análise Da Distribuição Multivetorial De Cargas Do Assoalho Pélvico Feminino Em Diferentes Populações / Licia Pazzoto Cacciari -- São Paulo, 2017
    LICIA PAZZOTO CACCIARI Análise da distribuição multivetorial de cargas do assoalho pélvico feminino em diferentes populações Tese apresentada à Faculdade de Medicina da Universidade de São Paulo para obtenção do título de Doutora em Ciências Programa de Ciências da Reabilitação Orientadora: Profa. Dra. Isabel de Camargo Neves Sacco SÃO PAULO 2017 LICIA PAZZOTO CACCIARI Análise da distribuição multivetorial de cargas do assoalho pélvico feminino em diferentes populações Tese apresentada à Faculdade de Medicina da Universidade de São Paulo para obtenção do título de Doutora em Ciências Programa de Ciências da Reabilitação Orientadora: Profa. Dra. Isabel de Camargo Neves Sacco SÃO PAULO 2017 Dados Internacionais de Catalogação na Publicação (CIP) Preparada pela Biblioteca da Faculdade de Medicina da Universidade de São Paulo ©reprodução autorizada pelo autor Cacciari, Licia Pazzoto Análise da distribuição multivetorial de cargas do assoalho pélvico feminino em diferentes populações / Licia Pazzoto Cacciari -- São Paulo, 2017. Tese (doutorado)--Faculdade de Medicina da Universidade de São Paulo. Programa de Ciências da Reabilitação. Orientadora: Isabel de Camargo Neves Sacco. Descritores: 1.Biomecânica 2.Assoalho pélvico. 3.Cargas internas 4.Mulheres 5.Treinamento USP/FM/DBD-228/17 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Aos meus pais e ao Gui, 22 com muito amor 23 24 iii ACKNOWLEDGEMENTS 25 26 Agradeço a todos que me acompanharam, apoiaram e incentivaram ao longo 27 destes quatro anos de estudo, dedicação e aprendizado. 28 Ao Gui, que se debruçou e se aprofundou comigo em cada conquista e desafio, 29 que tornou possível e prazerosa cada superação que vivenciamos juntos.
    [Show full text]
  • What I Need to Know About Bladder Control for Women
    What I need to know about BladderBladder ControlControl forfor WomenWomen U.S. Department NATIONAL INSTITUTES OF HEALTH of Health and National Kidney and Urologic Diseases Information Clearinghouse Human Services What I need to know about Bladder Control for Women NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse Contents Urine Leakage: A Common Health Problem for Women of All Ages ................................................................ 1 How does the bladder work?................................................. 2 What are the different types of bladder control problems? ................................................................................ 5 What causes bladder control problems? .............................. 7 How do I tell my health care team about my urine leakage?................................................................................... 9 How is loss of bladder control treated?.............................. 11 Hope Through Research...................................................... 17 For More Information.......................................................... 18 Acknowledgments................................................................. 19 *Inserts in back pocket A. What Your Doctor Needs to Know B. Your Daily Bladder Diary C. Kegel Exercise Tips D. Medicines for Bladder Control Urine Leakage: A Common Health Problem for Women of All Ages You may think bladder control problems are something that happen when you get older. The truth is that women of all ages have urine
    [Show full text]
  • 13 Artigo INGLES
    Santos AG, Almeida NAS, Jorge LB, Xavier SS, Latorre GS EFFECTIVENESS OF PELVIC FLOOR EXERCISES IN THE PERIOPERATIVE PERIOD OF RADICAL PROSTATECTOMY: A LITERATURE REVIEW Efetividade do exercício pélvico no perioperatório de prostatectomia radical: revisão de literatura Efectividad del ejercicio para el suelo pélvico en el perioperatorio Review Article de prostatectomía radical: revisión de literatura ABSTRACT (1) Objective: To review the literature on the effectiveness of pelvic floor exercises in the Adonivia Guimarães Santos perioperative period of radical prostatectomy. Methods: By using the health descriptors Nayara Alexandre de Souza de (DeCS) (prostatectomy) AND (physiotherapy) AND (pelvic floor) AND (urinary Almeida(1) incontinence), articles were selected in English, Spanish and Portuguese, regardless of Luisa Braga Jorge(2) the year of publication. After searching in the BVS database, 26 studies were found: 17 in Stanley Soares Xavier(3) MEDLINE, 5 in IBECS, 2 in LILACS, and 2 in CENTRAL. Of this total, 17 were excluded Gustavo Sutter Latorre(1) because they did not meet the study inclusion criteria, culminating in a total of 9 articles, which were analyzed in this study. Results: Pelvic floor muscle strengthening exercises in the prostatectomy perioperative period have important results in terms of minimizing urinary incontinence, considering the strong impact of the problem on the patients’ quality of life. Conclusion: Scientific evidence points out, despite the heterogeneity of techniques and samples, that the perioperative exercises show promising results in reducing postoperative urinary incontinence, mainly speeding recovery and healing or reducing the symptoms. Descriptors: Prostatectomy; Physical Therapy Specialty; Pelvic Floor; Urinary Incontinence. RESUMO 1) Inspirar College (Faculdade Inspirar) - Curitiba (PR) - Brazil Objetivo: Realizar uma revisão na literatura sobre a efetividade dos exercícios pélvicos 2) Pontifical Catholic University Pontifícia( no perioperatório de prostatectomia radical.
    [Show full text]