OBJETIVO: investigar a relação entre percepção da dor (limiar e tolerância à dor experimental em resposta à isquemia e à pressão) em mulheres jovens e saudáveis com os níveis séricos dos hormônios sexuais femininos (estradiol e progesterona). MÉTODOS: 18 voluntárias participaram deste estudo durante três ciclos menstruais consecutivos. Para mensuração das respostas dolorosas aos estímulos algésicos de pressão e isquemia, utilizaram-se um algômetro de pressão e dinamômetro manual, respectivamente. Foram realizadas coletas de sangue para dosagem hormonal e de variáveis dolorosas durante três ciclos menstruais consecutivos, os quais foram caracterizados com base no registro da temperatura oral diária, diário dos ciclos menstruais contendo início e fim de cada ciclo e nos níveis plasmáticos de estradiol e progesterona. As médias aferidas para as variáveis algésicas foram comparadas pela análise de variância (ANOVA) com pós-teste de Tukey-Kramer entre as fases do ciclo menstrual (folicular, periovulatória, luteal inicial, luteal tardia e menstrual). Para o estudo da correlação entre as variáveis algésicas e hormonais, utilizou-se o teste de Pearson. A significância estatística foi definida pelo limite p<0,05. RESULTADOS: não foram observadas variações significativas nos parâmetros de dor entre as fases do ciclo menstrual. Todavia, foram encontradas correlações negativas significativas entre progesterona e limiar isquêmico (r=-0,23; p<0,01) e tolerância à pressão (r=-0,23; p<0,01) na fase luteal inicial. CONCLUSÕES: estes resultados indicam que o aumento dos níveis de progesterona estão relacionados à diminuição do limiar isquêmico e da tolerância à pressão, sugerindo um papel da progesterona na modulação dolorosa durante a fase luteal inicial.

BRUNO, S. S. ; SOUSA, M. B. C. . Modulação pela progesterona da sensibilidade dolorosa a estímulos mecânicos e isquêmicos em mulheres saudáveis e jovens. RBGO. Revista Brasileira de Ginecologia e Obstetrícia , v. 30, p. 306-311, 2008

Dentre as especialidades da Fisioterapia, a área da saúde da mulher está crescendo e mostrando sua importância tanto para profissionais da saúde quanto para a sociedade. Observa-se um alto número de profissionais no mercado em busca de conhecimentos teóricos e práticos sobre a reabilitação da musculatura do assoalho pélvico. Dividido em sete capítulos, o livro “Incontinência urinária feminina: da avaliação à Reabilitação” apresenta a disfunção uroginecológica mais frequente, abordando os conceitos, prevalência, fisiopatologia, forma de avaliação e tratamento, além de exemplificar casos clínicos baseados na vivência dos colaboradores que são docentes e profissionais atuantes na área.

Abstract AIMS Changes resulting from the gestational period may lead to changes in the biomechanics of women, which can alter the performance of functional activities such as sit-to-stand. Thus, the objective of this study was to investigate the influence of a virtual reality-based exercise protocol on the kinematic variables of the sit-to-stand movement in women in their second and third gestational trimesters. METHODS The sample consisted of 44 women selected according to the eligibility criteria, allocated into 4 groups: control group, 2nd trimester (CG2T); experimental group, 2nd trimester (EG2T); control group, 3rd trimester (CG3T); and experimental group, 3rd trimester (EG3T). All the volunteers answered the identification and evaluation form and were sent to the kinematic evaluation through the Qualisys Motion Capture System®. An intervention with game therapy was performed in 12 sessions of 30 minutes each, three times a week. RESULTS No statistically significant differences were found intra- (P> 0.54) and inter-groups (P> 0.059) for kinematic variables. However, there was a tendency for improvement in the analyzed variables after the proposed protocol. CONCLUSIONS The data obtained suggest that the use of the Nintendo Wii Fit Plus® was not able to influence sit-to-stand kinematic variables in the analyzed women.

Abstract Introduction: During pregnancy women undergo several transformations, which promote changes in their gravity center (GC) and can result in postural and balance changes. Objective: To evaluate the influence of Nintendo WiiFit Plus® on postural balance and quality of life of pregnant women in the third trimester. Methods: 250 pregnant women enrolled through a non-probabilistic sampling process. The sample consisted of 32 women selected according to the eligibility criteria (nulliparity; low-risk pregnancy, absence of musculoskeletal disorders or surgical procedures in the spine, pelvis, hip or knee), musculoskeletal disorders, allocated as follows: 17 pregnant women in the control group (CG) and 15 pregnant women in the experimental group (EG). The intervention was performed in 12 sessions of 30 minutes each, three times a week. Sociodemographic and obstetric data were presented as median and interquartile range (25% - 75%). A comparison of the relative values of variables before and after the exercise program was performed using the 2x2 ANOVA test (5% significance level). Results: There were no significant statistical differences in variables related to postural balance (P > 0.06) and quality of life (P > 0.13). Conclusion: The use of Nintendo WiiFit Plus games was not able to promote improvement in postural balance and quality of life of the pregnant women studied.

Abstract BACKGROUND Physical activity during pregnancy provides countless benefits to pregnant women and results in a smaller number of falls during pregnancy. Thus, this study aims to verify the influence of physical activity and test conditions on the static and dynamic balance of pregnant women. METHODOLOGY The study was an analytical, transversal, and comparative study with a sample of 99 pregnant women divided into two groups, with physical activity as the grouping factor. The evaluation included questions about the type and frequency of physical activity and investigation of postural balance (Balance Master System(r)). For statistical analysis, we used the following tests: Shapiro Wilk, Mann-Whitney, ANOVA One Way and Wilcoxon. RESULTS No relationship was found between physical activity and postural balance (F > 0.40, P > 0.07). However, the test conditions alter the sway velocity (P = 0.001) and directional control movement (P = 0.001). CONCLUSIONS Results suggest that: (1) physical activity does not influence variables related to postural balance in active and sedentary pregnant women; and (2) postural sway velocity and directional control of movement are related to the test conditions used during balance evaluation.

Introduction Pregnancy is characterized by several changes in her body. These changes contribute to the emergence of low back pain, which may influence the quality of sleep during pregnancy. Objective To compare the quality of sleep among pregnant women with and without low back pain during pregnancy, examining the relationship between two variables. Materials methods Thirty volunteers aged between 19 and 36 years, divided into control group (CG – n = 16) and Study Group (SG – n = 14), residents in the cities of Natal, were evaluated in the second trimester of pregnancy. To sleep evaluation were used to index the Pittsburgh Sleep Quality and the Epworth Sleepiness Scale. Low back pain was evaluated using the pressure algometer, Visual Analogue Scale (VAS) and Oswestry Disability Index. Statistical analysis used the Shapiro Wilk test, Student’s T test for independent samples and Pearson correlation test. Results The mean gestational and chronological ages were 28.2 ± 3.4 years and 19.9 ± 3.7 weeks, respectively. Sleep quality was lower in SG (8.21 ± 4.8) when compared to CG (5.94 ± 1.7) and was statistically significant (P = 0.021). Analyzing the relationship between sleep quality and pain intensity, it was observed that the variables have a positive correlation between them (r = 0.372, P = 0.043). Conclusion Our findings indicate that sleep quality is decreased in women with low back pain compared to those without pain.

OBJETIVO: Investigar a relação entre função sexual e qualidade de vida em mulheres grávidas, residentes em duas cidades do Nordeste. MÉTODOS: A amostra constituiu-se de 207 gestantes. A coleta de dados foi feita por meio da aplicação de questionário contendo questões sobre dados sociodemográficos, ginecológicos e obstétricos, conhecimento corporal e sexual. A qualidade de vida foi avaliada através da aplicação do Índice de Qualidade de Vida Ferrans & Powers (IQV Ferrans e Power). A função sexual foi avaliada por meio do Índice de Função Sexual Feminina (IFSF). Foram realizados os testes estatísticos de Shapiro-Wilk, Mann-Whitney e Wilcoxon para análise dos dados coletados. RESULTADOS: As gestantes avaliadas apresentaram idade mediana de 30 anos (quartil 26-33 anos) e estavam aproximadamente na 26a semana gestacional. Observou-se diminuição significativa da frequência mensal do relacionamento sexual do casal, que passou de uma mediana de 12 para 4 vezes por mês (Z =-10,56; p<0,001). A disfunção sexual se mostrou presente em 35,7% das gestantes avaliadas, e a qualidade de vida dessas foi inferior quando comparada àquelas com função sexual sem alteração (Z=-2,87; p=0,004). CONCLUSÃO: Os resultados do presente estudo mostram que a disfunção sexual afetou negativamente a qualidade de vida de mulheres grávidas, devendo ser um aspecto relevante para ser avaliado durante as consultas de pré-natal.

Abstract Introduction: Brazil presents high C-section prevalence rates. Several factors may be associated with such high rates. Objective: To observe and analyze factors associated with the prevalence of cesarean sections in Brazil, according to their occurrence in Brazilian regions. Methods: An ecological study, having C-section as the outcome, from 1990 to 2013, in Brazilian regions, using data from the Brazilian National Health Survey, 2013. Records of women in their reproductive period, aged between 18 and 49 years, were included, totaling a sample of 16,175 women. Descriptive and bivariate analysis was carried out with logistic regression. Results: The prevalence of cesarean sections in Brazil was 53.03%. Vaginal delivery was more prevalent in the North (52.74%) and Northeast (51.06%) regions, while C-section was more prevalent in the Southeast (59.32%), South (56.96%) and Midwest (61.48%) regions. Over the years, an increased probability of cesarean sections was observed, particularly in the following regions: Northeast (2.21 times more, CI95%: 1,42 - 3,46) and South (2.75 times more, CI95%: 1,44 - 5,23). Women with higher levels of education are 2.05 times (CI95%: 1.27 - 3.30) more likely to have a C-section, especially those in the Northern and Southern regions. In the Northeast, this probability increased, regardless of the level of education. Conclusion: The prevalence of cesarean sections in Brazil is high and, over the years, factors such as level of education, maternal age and having health insurance, seem to contribute to the increase in surgical deliveries.

Abstract Introduction: The emergence of painful pathologies during gestation, such as lumbopelvic pain (LPP), can influence in the achievement of functional activities, such as sit-to-stand, throughout the gestational period. Objective: To compare the variables of static and dynamic postural balance (sit-to-stand activity) among pregnant women with and whitout lumbopelvic pain and the outcome variables between the gestational trimesters. Method: A total of 100 pregnant women participated in this study allocated as follows: 51 in the LPP group and 49 in the group without LPP. All participants were subjected to an evaluation protocol: filling an identification form, Analogic Visual Scale (AVS) and Oswestry Disability Index (ODI). Evaluation of postural balance was subsequently performed using the Balance Master System®. Results: 64.7% of women during the third trimester of pregnancy reported LPP. No statistically significant differences were found between LBP presence or absence in postural balance variables (p>0.05). However, gestational age influenced the VFEC variable (p=0.001). Conclusion: Women during the third gestational trimester presented complaints of lumbopelvic pain. However, the data acquired suggest that women with LPP do not have alterations in postural balance during sit-to-stand movement when compared to pregnant women without pain.