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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(07): 535-544
DOI: 10.1055/s-0041-1733979
Original Article | Artigo Original
Urogynecology

Can Supervised Pelvic Floor Muscle Training Through Gametherapy Relieve Urinary Incontinence Symptoms in Climacteric Women? A Feasibility Study

O treinamento por meio de gameterapia pode aliviar os sintomas de incontinência urinária em mulheres climatéricas? Um estudo de viabilidade
Anita Bellotto Leme Nagib 
1   Faculty of Medical Sciences, Statel University of Campinas, UNICAMP, Campinas, SP, Brazil
2   University Center of Associated Colleges, São João da Boa Vista, SP, Brazil
,
Valeria Regina Silva 
1   Faculty of Medical Sciences, Statel University of Campinas, UNICAMP, Campinas, SP, Brazil
3   University José do Rosário Vellano, UNIFENAS, Alfenas, MG, Brazil
,
Natalia Miguel Martinho 
1   Faculty of Medical Sciences, Statel University of Campinas, UNICAMP, Campinas, SP, Brazil
2   University Center of Associated Colleges, São João da Boa Vista, SP, Brazil
4   Regional University Center of Espírito Santo do Pinhal, UNIPINHAL, Espírito Santo do Pinhal, SP, Brazil
,
Andrea Marques 
5   Physical Therapy Service, Center for Integral Attention to Women's Health – Women's Hospital Prof. Dr. José Aristodemo Pinotti, CAISM, State University of Campinas, UNICAMP, Campinas, SP, Brazil
,
Cassio Riccetto 
1   Faculty of Medical Sciences, Statel University of Campinas, UNICAMP, Campinas, SP, Brazil
,
Simone Botelho 
1   Faculty of Medical Sciences, Statel University of Campinas, UNICAMP, Campinas, SP, Brazil
6   Postgraduate Program in Rehabilitation Sciences - Motor Science Institute - Federal University of Alfenas, UNIFAL-MG, Alfenas, MG, Brazil
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Abstract

Objective To investigate the feasibility of pelvic floor muscle training (PFMT) through gametherapy for relieving urinary symptoms of climacteric women with stress or mixed urinary incontinence (UI).

Methods Randomized clinical trial, divided into two groups: Gametherapy (G_Game) and Control (G_Control). Both groups received recommendations about unsupervised PFMT, and G_Game also received supervised PFMT through gametherapy. After 5 consecutive weeks, the feasibility was investigated considering participant adherence, urinary symptoms (evaluated by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF] questionnaire), and pelvic floor function (PERFECT Scheme: power, endurance, repetition and fast). The Fisher exact, Kruskal-Wallis, Wilcoxon sign paired, and Mann-Whitney U tests were used by intention-to-treat analysis, using STATA 15.1 (StataCorp, College Station, TX, USA) software.

Results The present study included 20 women per group and observed a higher adherence in G_Game. In the intragroup analysis, a decrease in the ICIQ-UI-SF score was observed in both groups (14.0 to 10.0; 13.5 to 0), associated with increased endurance (2.5 to 3.5; 2.5 to 4.0) in G_Control and G_Game, respectively. Moreover, there was a concomitant increase in pelvic floor muscles (PFMs) power (2.0 to 3.0), repetition (3.0 to 5.0), and fast (10.0 to 10.0) in G_Game. In the intergroup analysis, a reduction of UI was observed (p < 0.001; r = 0.8), as well an increase in PFM power (p = 0.027, r = 0.2) and endurance (p = 0.033; r = 0.3) in G_Game.

Conclusion The feasibility of supervised PFMT through gametherapy was identified by observing participant adherence, relief of urinary symptoms, and improvement in PFM function.

Resumo

Objetivo Investigar a viabilidade do treinamento dos músculos do assoalho pélvico (TMAP) por meio de gameterapia no alívio de sintomas urinários em mulheres climatéricas com incontinência urinária (IU) de esforço ou mista.

Métodos Ensaio clínico randomizado, dividido em dois grupos: Gameterapia (G_Game) e Controle (G_Controle). Ambos os grupos receberam recomendações sobre TMAP não supervisionado, e G_Game também recebeu TMAP supervisionado por meio de gameterapia. Após 5 semanas consecutivas, a viabilidade foi investigada considerando a aderência das participantes, sintomas urinários (avaliados pelo questionário International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF]) e função do assoalho pélvico (esquema PERFECT: power, endurance, repetition, fast). Os testes exatos de Fisher, Kruskal-Wallis, sinal de Wilcoxon pareado e Mann-Whitney U foram usados pela análise de intenção de tratar, usando o software STATA 15.1 (StataCorp, College Station, TX, EUA).

Resultados O presente estudo incluiu 20 mulheres por grupo e observou uma maior adesão no G_Game. Na análise intragrupo, foi observada diminuição no escore do ICIQ-UI-SF em ambos os grupos (de 14,0 para 10,0; de 13,5 para 0), associada ao aumento da resistência (de 2,5 para 3,5; de 2,5 para 4,0) em G_Control e G_Game, respectivamente. Além disso, houve um aumento concomitante no power (de 2,0 para 3,0), repetition (de 3,0 para 5,0) e fast (de 10,0 para 10,0) dos músculos do assoalho pélvico (MAPs) no G_Game. Na análise intergrupos, foi observada redução da IU (p < 0,001; r = 0,8), assim como do power (p = 0,027; r = 0,2) e da endurance (p = 0,033; r = 0,3) dos MAPs no G_Game.

Conclusão A viabilidade do TMAP supervisionado por meio de gameterapia foi identificada pela observação da aderência das participantes, pelo alívio dos sintomas urinários e pela melhora da função dos MAPs.

Keywords

pelvic floor dysfunctions - urinary incontinence - pelvic floor muscle - gametherapy - climacteric - rehabilitation

Palavras-chave

disfunções do assoalho pélvico - incontinência urinária - músculos do assoalho pélvico - gameterapia - climatério - reabilitação

Contributions

All authors have contributed to the conception, design, data collection, analysis and interpretation, article essay and final approval of the text version to be published.




Publikationsverlauf

Eingereicht: 10. August 2020

Angenommen: 04. April 2021

Artikel online veröffentlicht:
30. August 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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