ELIZABETH ALVES GONCALVES FERREIRA

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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

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  • article 3 Citação(ões) na Scopus
    Sexual performance and pelvic floor muscle strength in patients with fibromyalgia: a controlled cross-sectional study
    (2021) FUSCO, Hellen Cristina Souza de Carvalho; PONTES FILHO, Marco Antonio; CONSOLO, Rafael Treitero; LUNARDI, Adriana Claudia; FERREIRA, Elizabeth Alves Goncalves
    Background Fibromyalgia (FM) is characterized by chronic and widespread pain, sleep disturbances, fatigue, psychological distress and morning stiffness. These patients also present symptoms such as depression, sexual dysfunctions and reproductive problems. Sexuality involves several aspects, including pelvic floor functionality, and one question is whether the sexual performance of women with fibromyalgia is associated with pelvic floor function or other characteristics of the disease. Objective The aim of this study was to gauge the association between perineal function and sexual performance in women with and without fibromyalgia. Methods We performed a cross-sectional study with 109 sexually active women from 19 to 65 years of age, either suffering from fibromyalgia (FM group, n = 51) or free from fibromyalgia (non-FM group, n = 58). Perineal function was measured with the use of perineometry and digital vaginal palpation (PERFECT Scheme), while sexual performance was assessed by the Sexual Quotient Female questionnaire (QS-F). Results Patients with fibromyalgia presented poor sexual performance compared to those without fibromyalgia (QS-F score 58 (32-66) vs. 66 (56-70); p = 0.002) as well as lower pelvic floor muscle strength measured by perineometry (32.5 (18.2-40.5) vs. 37.9 (23.4- 57.3); p = 0.03). Patients without fibromyalgia presented a positive correlation between perineometry and QS-F (r = 0.22; p = 0.038), while those with fibromyalgia presented no correlation between those two variables (r = 0.22; p = 0.12). The regression model showed an association between sexual performance and the presence of fibromyalgia, pelvic floor muscle strength (perineometry) and age, according to the following equation: sexual performance = 48.52 + (9.5 * non-FM group) + (0.23 * perineometry)-(0.4 * age), with adjusted R-2 = 0.19. Conclusion Women with FM present poor sexual performance and lower pelvic floor muscle strength compared to those without FM. However, the correlation between these variables among women without FM was not observed in women with FM. Sexual performance showed a positive association with absence of fibromyalgia and higher pelvic floor muscle strength, and a negative association with age.
  • 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
  • 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.
  • article 10 Citação(ões) na Scopus
    Effect of Pelvic Floor and Hip Muscle Strengthening in the Treatment of Stress Urinary Incontinence: A Randomized Clinical Trial
    (2020) MARQUES, Simone A. A.; SILVEIRA, Simone R. B.; PASSARO, Anice C.; HADDAD, Jorge M.; BARACAT, Edmund C.; FERREIRA, Elizabeth A. G.
    Objective: To investigate the effectiveness of strengthening the hip muscles in addition to strengthening the pelvic floor muscles (PFM) in the treatment of stress urinary incontinence. Methods: This study used a prospective, assessor-blind, randomized clinical trial with parallel groups. We randomly allocated 47 individuals with stress urinary incontinence to 2 groups: 1 performing only pelvic floor strengthening exercises (PF, n = 21) and the other performing pelvic floor strengthening exercises plus exercises for the gluteus maximus and medius and hip adductor muscles (PFH, n = 22). Four individuals did not complete the study. Frequency of urine leakage was the primary outcome (3-day voiding diary and a follow-up voiding diary). Secondary outcomes were pelvic floor muscle strength (Ortiz scale, PERFECT scheme [Oxford Scale], and perineometry) and quality of life (QoL; International Consultation on Incontinence Questionnaire-Short Form and King's Health Questionnaire), which were evaluated by a blinded assessor before and after 20 sessions over 10 weeks. Results: Regarding the daily frequency of urine loss evaluated by the follow-up voiding diary, an effect of group was observed (P < .001), with the PFH group showing a significant decrease in daily loss frequency, although no significant differences were found in the comparison between groups for the 3-day voiding diary, QoL, or functional assessment of the PFM. Conclusion: Strengthening the PFM together with the hip synergic muscles showed better results for frequency of daily urine loss throughout the sessions, although there was no accompanying superiority in improvement of strength, perineometry, or QoL over the group that performed only PFM-strengthening exercises.
  • article 1 Citação(ões) na Scopus
    Low- and high-frequency transcutaneous electrical nerve stimulation have no deleterious or teratogenic effects on pregnant mice
    (2015) YOKOYAMA, L. M.; PIRES, L. A.; FERREIRA, E. A. Goncalves; CASAROTTO, R. A.
    Objective To evaluate the effects of application of transcutaneous electrical nerve stimulation (TENS) at low and high frequencies to the abdomens of Swiss mice throughout pregnancy. Design Experimental animal study. Setting Research laboratory. Participants Thirty Swiss mice received TENS throughout pregnancy. They were divided into three groups (n = 10): placebo, low-frequency TENS (LF group) and high-frequency TENS (HF group). Interventions In the placebo group, the electrodes were applied to the abdominal region without any electrical current. In the LF group, the frequency was 10 Hz, pulse duration was 200 us and intensity started at 2 mA. In the HF group, the same parameters were applied and the frequency was 150 Hz. All stimulation protocols were applied for 20 min/day from Day 0 until Day 20. Main outcome measures The pregnant mice were weighed on Days 0, 7, 14 and 20 to verify weekly weight gain by two-way analysis of variance. The numbers of fetuses, placentas, implantations, resorptions and major external fetal malformations on Day 20 were analysed using the Kruskal Wallis test. Results No significant differences were found between the placebo and TENS groups (P > 0.05). Conclusion Application of low- and high-frequency TENS to the abdomens of pregnant mice did not cause any deleterious or major teratogenic effects.
  • article
    Inter- and intra-rater reliability of computerized photogrammetry and universal goniometer in the measurement of hip flexion and abduction
    (2017) MARQUES, Amélia Pasqual; MARCOLAN, Juliana Naomi Oshima; PRADO, Juliana Nucci Nogueira; BURKE, Thomaz Nogueira; FERREIRA, Elizabeth Alves Gonçalves
    ABSTRACT The universal goniometer (UG) is the most frequently used tool for measuring range of motion (ROM), with demonstrated reliability. Computerized photogrammetry (CP) is widely used for postural assessment, but its role in the measurement of ROM of hip flexion and abduction has not yet been fully explored. This study aimed to test inter- and intra-rater reliability for measuring ROM of hip flexion and abduction using UG and CP, as well as the reliability between the instruments. Our sample consisted of 40 healthy volunteers (aged from 18 to 28 years). Measurements of ROM were conducted by two independent raters, 15 minutes apart, using UG and CP to assess inter-rater reliability. The procedures were repeated one week later by the first rater (intra-rater reliability). Using UG, inter-rater reliability was excellent for flexion and abduction (ICC=0.92 and 0.91, respectively); using CP, it was rated as very good (ICC=0.77 and 0.80, respectively). Intra-rater reliability using UG was excellent for flexion and abduction (ICC=0.95 and 0.92), and very good using CP (ICC= 0.81 and 0.89). The correlation between the instruments was excellent for flexion and very good for abduction (r=0.92 and r=0.82). Future investigations should seek a more diversified sample and symptomatic patients. Inter- and intra-rater reliability is high when measuring range of motion of hip flexion and abduction using both UG and CP, and the correlation between instruments is excellent for flexion and very good for abduction, meaning that both are valid.
  • article
    Two devices to facilitate the perception of pelvic floor muscle contraction in the sitting position in women with urinary incontinence: comparative analysis
    (2022) SAWADA, Thais Naomi; LUNARDI, Adriana Claudia; CARRO, Daniela Fantin; PORTO, Débora Françoes; SILVEIRA, Leda Tomiko Yamada da; FERREIRA, Elizabeth Alves Gonçalves
    ABSTRACT The use of support devices may facilitate the perception of pelvic floor muscle (PFM) contraction, which is difficult to be performed. Therefore, this study aimed to compare the perception of PFM contraction in the sitting position during the use of two different support devices on women with PFM dysfunction. This is a cross-sectional study performed with 37 women with stress or mixed urinary incontinence (UI). All women performed three free PFM contractions sitting on a chair, followed by three contractions using each support device (sand pads and a cylindrical foam, which provide sciatic and perineal support, respectively). Women scored the perception of PFM contraction from 1 to 5, as well as the perception of facilitation of contraction (higher grades show better results) and discomfort (higher grades show more discomfort) when compared with free contraction. The cylindrical foam presented similar results to sand pads for the perception of PFM contraction (2.84±1.61 vs. 3.19±1.43; p=0.34) and facilitation of contraction (3.38±1.34 vs. 3.19±1.54; p=0.61), as well as for their discomfort (1.83±1.23 vs. 1.5±1.16; p=0.20). Of all women, 57% preferred sand pads. Thus, both sand pads (sciatic support) and the cylindrical foam (perineal support) improved the perception of PFM contraction and facilitation of contraction in the sitting position of women with PFM dysfunction when compared with sitting with no device. The two devices presented no difference between them.
  • article 4 Citação(ões) na Scopus
    Comparison of transcutaneous electrical tibial nerve stimulation for the treatment of overactive bladder: a multi-arm randomized controlled trial with blinded assessment
    (2021) PIERRE, Munick Linhares; FRISO, Beatriz; CASAROTTO, Raquel Aparecida; HADDAD, Jorge Milhem; BARACAT, Edmund Chada; GONC, Elizabeth Alves
    OBJECTIVE: To compare the effectiveness of tibial nerve transcutaneous electrical nerve stimulation (TENS) for an overactive bladder, considering the sites of application and frequency of attendance. METHODS: This multi-arm randomized controlled trial enrolled 137 adult women (61.0 +/- 9.0 years) with overactive bladder from a university hospital. They underwent 12 sessions of 30-min TENS application and were assigned to five groups: one leg, once a week (n=26); one leg, twice a week (n=27); two legs, once a week (n=26); two legs, twice a week (n=28); and placebo (n=30). Symptoms of overactive bladder and its impact on quality of life were evaluated before and after 6 or 12 weeks of treatment using the Overactive Bladder Questionnaire-V8 and voiding diary. ClinicalTrials.gov: NCT01912885. RESULTS: The use of one leg, once a week TENS application reduced the frequency of urgency episodes compared with the placebo (1.0 +/- 1.6 vs. 1.4 +/- 1.9; p=0.046) and frequency of incontinence episodes compared with the placebo (0.7 +/- 1.4 vs.1.4 +/- 2.2; p<0.0001). The one-leg, twice a week protocol decreased the urinary frequency compared with the two legs, once a week protocol (8.2 +/- 3.5 vs. 9.0 +/- 5.1; p=0.026) and placebo (8.2 +/- 3.5 vs. 7.9 +/- 2.7; p=0.02). Nocturia improved using the two legs, once a week protocol (1.5 +/- 1.8) when compared with the one leg, twice a week protocol (1.9 +/- 2.0) and placebo (1.7 +/- 1.6) (p=0.005 and p=0.027, respectively). Nocturia also improved using the two legs, twice a week protocol when compared with the one leg, twice a week protocol (1.3 +/- 1.2 vs.1.9 +/- 2.0; p=0.011). CONCLUSION: One-leg stimulation improved the daily urinary frequency, urgency, and incontinence, and the two-leg stimulation once and twice weekly improved nocturia.
  • bookPart
    Dores lombares
    (2013) JOãO, Sílvia Maria Amado; MARQUES, Amélia Pasqual; FERREIRA, Elizabeth Alves Gonçalves