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- ItemAcesso aberto (Open Access)Efeito da adição do biofeedback ao treinamento dos músculos do assoalho pélvico para tratamento da incontinência urinária de esforço(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2012-11-01) Fitz, Fátima Faní [UNIFESP]; Resende, Ana Paula Magalhães [UNIFESP]; Stüpp, Liliana [UNIFESP]; Costa, Thaís Fonseca [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Castro, Rodrigo de Aquino [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To investigate the effect of adding biofeedback (BF) to the training of pelvic floor muscles (PFMT) for the treatment of stress urinary incontinence (SUI). METHODS: A prospective pilot study, randomized and controlled with women with SUI without sphincter deficiency, detected by urodynamic study and who performed the correct PFM contraction. Women with neuromuscular disorders and grade III and IV genital prolapse were excluded. Forty women were randomized into a Control Group and BF Group. The PFMT protocol with BF equipment consisted of three sets of ten slow contractions (tonic), with a holding time of six to eight seconds at each contraction followed by a rest period of equal duration. After each sustained contraction, they performed three to four fast contractions (phasic) in the supine and standing position twice a week, for a total of 12 sessions. We evaluated the effect of adding BF to PFMT on quality of life using King's Health Questionnaire (KHQ) regarding urinary symptoms based on a voiding diary and regarding the function of pelvic floor muscles by digital palpation. The evaluation was performed initially and after 12 treatment sessions. Data are reported as mean and standard deviation. The Mann-Whitney test was used for the analysis of homogeneity and to determine differences between groups, and the Wilcoxon test was used to determine possible differences between the times of observation, with the level of significance set at 0.05. RESULTS: A significant decrease in the scores of the domains assessed by the KHQ was observed in the comparison between groups, except for the general health domain (BF Group: 32.8±26.9 versus Control Group: 48.4±29.5, p<0.13). Accordingly, there was improvement in PFM function after treatment in the BF Group, regarding power (4.3±0.8, p= 0.001), endurance (6.0±2.2, p<0.001) and fast (9.3±1.9, p=0.001). When comparing the groups, the BF Group showed a positive result regarding power (BF Group 4.3±0.8 versus Control Group 2.5±0.9, p<0.001), endurance (6.0±2.2 BF Group versus Control Group 2.7±1.9, p<0.001) and fast (BF Group 9.3±1.9 versus Control Group 4.6 ± 3.2, p<0.001). Reduction of nocturnal urinary frequency (1.2±1.2 versus 0.7±0.9, p=0.02) and of effort urine loss (1.5±1.4 versus 0.6±0.8, p=0.001) was observed in the BF Group. CONCLUSION: The addition of BF to the PFMT for the treatment of SUI, applied according to the protocol described, improved PFM function, reduced urinary symptoms, and improved of the quality of life.
- ItemAcesso aberto (Open Access)Treinamento muscular na face: a prática dos fonoaudiólogos de Belo Horizonte(Sociedade Brasileira de Fonoaudiologia, 2008-06-01) Coutrin, Grazielle Costa; Guedes, Luciana Ulhôa; Motta, Andréa Rodrigues [UNIFESP]; Centro FEAD de Fonoaudiologia; Centro de Estudos Superiores de Juiz de Fora; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Minas Gerais Departamento de FonoaudiologiaPURPOSE: To verify the practice of the speech-language pathologist who acts in orofacial myology in Belo Horizonte - MG (Brazil) concerning facial muscular training, and to compare orofacial myology specialists and nonspecialists' conducts. METHODS: Sectional study, with application of a questionnaire to 60 speech-language pathologists (SLP) from Belo Horizonte - MG (Brazil) who attend orofacial myology patients: 30 graduate without specialization and 30 specialized in orofacial myology. The questionnaire presented a case report and 12 questions regarding conducts in myotherapy. Data analysis used Chi-square and Fisher's Exact Test, and considered a significance level of 5%. RESULTS: In the researched sample, 88.3% of the SLP mentioned isometric exercises, 63.3% requested a training frequency of three times a day and 81.7% seven days a week. The variation of time of muscular contraction was mentioned by 61.7%, and 40% recommend time increase. They indicated the need to vary the number of series of exercises along the therapeutic process in 50% of the interviews, and 26.7% of these mentioned decrease of this number. Regarding frequency, 43.3% considered necessary to vary the frequency of exercises along the therapeutic process: 20% reducing the number of repetitions of the exercise per day and 23.3% reducing the number of days a week. More than half of the professionals (56.7%) informed that the average time of intervention for orofacial myology varied from four to six months. CONCLUSION: The majority of the SLP interviewed for this study employ isometric exercises, three times a day, seven days a week, for an average period of four to six months of therapy. There was no significant difference between the conduct of specialized and nonspecialized speech-language pathologists.