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
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conferenceObject A review of mobile voiding diary apps: Content and functionality features(2018) VACCARI, N.; SILVEIRA, L.; HADDAD, J.; BARACAT, E.; BERTOLINI, M. A.; FERREIRA, E.conferenceObject Transcutaneous tibial nerve electrical stimulation combined with transvaginal electrical stimulation in the treatment of overactive bladder syndrome: a blind randomized clinical trial(2018) GIARRETA, F.; HADDAD, J.; FUSCO, H.; BARACAT, E.; CASAROTTO, R.; FERREIRA, E.conferenceObject EFFECT OF PELVIC FLOOR AND HIP MUSCLE STRENGTHENING IN THE TREATMENT OF STRESS URINARY INCONTINENCE: RANDOMIZED BLIND CLINICAL TRIAL(2015) MARQUES, S. A.; SILVEIRA, S. B.; HADDAD, J. M.; PASSARO, A. C.; EDMUND, B. C.; FERREIRA, E. A.- A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic(2021) FERREIRA, Cristine Homsi Jorge; DRIUSSO, Patricia; HADDAD, Jorge Milhem; PEREIRA, Simone Botelho; FERNANDES, Ana Carolina Nociti Lopes; PORTO, Debora; REIS, Bianca Manzan; MASCARENHAS, Lilian Rose; BRITO, Luiz Gustavo Oliveira; FERREIRA, Elizabeth Alves GoncalvesIntroduction and aim Physiotherapy in urogynecology faces challenges to safely continuing its work, considering the adoption of social distancing measures during the COVID-19 pandemic. Some guidelines have already been published for urogynecology; however, no specific documents have been produced on physiotherapy in urogynecology. This article aimed to offer guidance regarding physiotherapy in urogynecology during the COVID-19 pandemic. Methods A group of experts in physiotherapy in women's health performed a literature search in the Pubmed, PEDro, Web of Science and Embase databases and proposed a clinical guideline for physiotherapy management of urogynecological disorders during the COVID-19 pandemic. This document was reviewed by other physiotherapists and a multidisciplinary panel, which analyzed the suggested topics and reached consensus. The recommendations were grouped according to their similarities and allocated into categories. Results Four categories of recommendations (ethics and regulation issues, assessment of pelvic floor muscle function and dysfunction, health education and return to in-person care) were proposed. Telephysiotherapy and situations that need in-person care were also discussed. Regionalization is another topic that was considered. Conclusion This study provides some guidance for continuity of the physiotherapist's work in urogynecology during the COVID-19 pandemic, considering the World Health Organization recommendations and the epidemiological public health situation of each region. Telephysiotherapy can also be used to provide continuity of the care in this area during the COVID-19 pandemic, opening new perspectives for physiotherapy in urogynecology.
- Is the addition of vaginal electrical stimulation to transcutaneous tibial nerve electrical stimulation more effective for overactive bladder treatment? A randomized controlled trial(2021) GIARRETA, F. Bacchi Ambrosano; HADDAD, J. Milhem; FUSCO, H. C. Souza de Carvalho; BARACAT, E. Chada; CASAROTTO, R. A.; FERREIRA, E. Alves GoncalvesIntroduction and objectives: Overactive bladder (OAB) is a prevalent disorder that increases with age and impairs patients' quality of life. Guidelines recommend behavior modifications as the first-line treatment; however, physiotherapy has also been used with success, safety, and low cost. Transcutaneous tibial nerve electrical stimulation (TINS) and vaginal electrical stimulation (VS) are being used in clinical physiotherapy practice. This study aimed to verify whether the addition of VS to TTNS is more beneficial than TINS alone for women with OAB. Patients and methods: In all, 106 women aged >18 years diagnosed with OAB or mixed urinary incontinence with prevalent OAB symptoms were randomly divided into 2 groups: Group 1: TTNS (n = 52); Group 2: TTNS + VS (n = 54). The 3 day voiding diary, pelvic floor muscle strength (Ortiz Scale), King's Health Questionnaire, and Overactive Bladder Questionnaire were assessed before and after treatment. Urinary frequency was considered the primary outcome, and a reduction of >= 3 micturitions/day was considered clinically relevant. Mixed linear models were used to compare the 2 groups. Results: Initially, the groups were similar in age, body mass index, number of pregnancies, time of OAB onset, and prevalence of OAB symptoms. After treatment, a reduction in urinary frequency of 1.5 micturitions was observed in Group 2, which was not clinically relevant despite being statistically significant. Conclusions: The addition of VS to TINS for the treatment of OAB was not more effective than TTNS as a single therapy.
- Content and functionality features of voiding diary applications for mobile devices in Brazil: a descriptive analysis(2020) VACCARI, Natalie Alves; SILVEIRA, Leda Tomiko Yamada da; BORTOLINI, Maria Augusta Tezelli; HADDAD, Jorge Milhem; BARACAT, Edmund Chada; FERREIRA, Elizabeth Alves GoncalvesIntroduction and hypothesis A voiding diary is a method to investigate lower urinary tract symptoms. The purpose was to elaborate a descriptive analysis of nonpaid voiding diaries for mobile applications and to compare them regarding their quality. Methods We searched the platforms of iTunes (Apple Inc., Brazil) and Google Play (Google Inc., Brazil) using the keywords: ""voiding diary,"" ""bladder diary,"" ""urinary diary,"" ""urinary incontinence,"" and ""pelvic floor."" Inclusion criteria were: apps free of charge and specific for voiding diaries in the Portuguese, Spanish, French, or English language. Exclusion criteria were: access or technical problems and pediatric apps. We quantitatively analyzed and compared the apps with each other according to their functionality features and voiding diary topics (type and volume of fluid intake, voiding episodes and volume, type and episodes of incontinence, amount of leakage, urgency, and use of pads and nocturia). We rated the apps using the Mobile App Rating Scale (MARS), whose scores for each feature vary from 1 (worst score) to 5 (best score). Results Fifty-five apps were eligible; 16 were included for analyses. None presented all 11 topics of the voiding diary, and the median number of available features was 6 (3.75-7). ""Incontinence episodes"" was present in eight apps, and ""nocturia"" was present in five. The mean score of apps ranged between 1.7 and 4.5. Conclusion There is variation in the content of voiding topics among the apps. Patients and professionals should choose the app based on the topics of most or particular interest.
- 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.