ELIZABETH ALVES GONCALVES FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
2 resultados
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- Electromyographic activity of pelvic floor muscles in different positions during the use an innovative vaginal educator: Cross-sectional study(2024) DUARTE, Natalia de Souza; AZEVEDO, Yury Souza De; FURTADO, Emilly Cassia Soares; ARAUJO, Lorena Jarid Freire De; BENDELACK, Rayanne Mesquita; RODRIGUES, Cibele Nazare Camara; ARAUJO, Nazete dos Santos; NEVES, Pablo Fabiano Moura das; SOARES, Ana Clara Nunes; BARROS, Rayana Carvalho; SANTOS, Tainah Lacerda; NUNES, Erica Feio Carneiro; FERREIRA, Elizabeth Alves Goncalves; CALLEGARI, Bianca; MELO-NETO, Joao Simao deThe pelvic floor requires an integrated anatomical structure owing to its multiple functions. Therefore, it is necessary to study methods for improving muscle recruitment during training. This study aimed to analyze the effect of using an innovative vaginal trainer on the bioelectrical activity of the pelvic floor muscles. Pelvic positioning and interference factors, such as age, childbirth, sexual activity, urinary incontinence, and menopause, were also analyzed. A cross-sectional study assessed 30 women using an evaluation form, International Consultation on Incontinence Questionnaire-Short Form, and surface electromyography. The root mean square of a 5-second contraction period, peak root mean square values, area values, % maximal voluntary contraction (root mean square normalized by peak signal), and median frequency were collected. These findings with and without the use of a vaginal educator were compared in the anteversion, neutral, and retroversion pelvic positions. The use of a vaginal educator was found to increase the electromyographic activity of the pelvic floor muscles in the neutral position. In this position, older women showed an increased peak contraction when using the educator. Multiparas also benefited from increased bioelectric activity (root mean square and area). Sexually active women increased their bioelectric activity in a neutral position when using the trainer, exerting less effort in retroversion (%-maximal voluntary contraction). Incontinent and menopausal women exhibited slower body-building activation (decreased frequency) with the device, which requires further investigation. Our innovative biofeedback device induced greater recruitment of muscle fibers, is more effective in the neutral pelvic position, and may be effective in training the pelvic floor muscles, even in women with a greater tendency toward pelvic floor dysfunction.
- A randomized trial comparing vaginal laser therapy and pelvic floor physical therapy for treating women with stress urinary incontinence(2023) FONSECA, Lucilia C. da; GIARRETA, Fernanda Bacchi Ambrosano; PETERSON, Thais V.; LOCALI, Priscila Katsumi Matsuoka; BARACAT, Edmund C.; FERREIRA, Elizabeth A. Goncalves; HADDAD, Jorge MilhemIntroductionFemale stress urinary incontinence (SUI) is considered a major public health issue. Physical therapy is an important conservative treatment; however, it is primarily limited by poor long-term compliance. Furthermore, surgical treatment entails significant risks. Therefore, new treatment techniques must be identified. ObjectiveTo compare the use of laser therapy and pelvic floor (PF) physical therapy for treating postmenopausal women with SUI. MethodsThis pilot study enrolled 40 women with a clinical and urodynamic diagnosis of SUI who were randomized into two groups: those who received erbium-doped yttrium-aluminum-garnet (Er:YAG) laser therapy implemented over three sessions with a 1-month interval (n = 20) and those who received physical therapy with supervision twice a week for 3 months (n = 20). In total, 16 women completed the treatment in each group. The patients were assessed for PF function using the modified Oxford scale and for pelvic organ prolapse using the Pelvic Organ Prolapse Quantification System. The 1-h pad test and quality of life questionnaires, King's Health Questionnaire (KHQ), and Incontinence Quality of Life (IQOL) were also administered. Patients were re-evaluated at 1, 3, 6, and 12 months after treatment. ResultsThe mean patient age was 62.7 & PLUSMN; 9.1 and 57.9 & PLUSMN; 6.1 years, median Oxford score at baseline was 3 (2-4.5) and 4 (3-4), mean IQOL score was 79.8 & PLUSMN; 17 and 74.6 & PLUSMN; 18 for physical therapy group (PTG) and laser group (LG), respectively. For the amount of urine leak in the 1-h pad test evaluation, we found significance for the interaction of group and time points only for the Laser intragroup. The cure rate, that is, the rate of reaching an insignificant score in the pad test, at 6 and 12 months was 43.75% and 50% in PTG and 62.5% and 56.25% in the LG, respectively (p > 0.05). IQOL scores demonstrated considerable improvement in both groups (p > 0.05). Upon comparing the initial and follow-up results, the LG showed an improvement at all consultations, whereas the PTG showed improvements at 1, 3, and 6 months but not at 12 months after treatment. KHQ analysis revealed a considerable improvement in the quality of life (QOL) of patients over time, with no substantial difference between the groups. QOL comparison before and after treatment revealed that the vaginal LG improved more consistently in some domains. Only the PTG showed a significant increase in the mean Oxford score from pretreatment to 1 and 3 months after treatment (p < 0.001 and p = 0.002, respectively). However, no statistically significant difference was observed between the groups. ConclusionBoth treatments are safe and have a positive influence on the impact of UI on patients' QOL. The laser caused a greater reduction in the urinary loss, as measured using the weight of pad test, at 6-month and 12-month after treatment without difference with PTG at the end of the follow-up.