Sara Viana
@ufp.pt
University Fernando Pessoa
Scopus Publications
Scopus Publications
Telma Pires, Patrícia Pires, Helena Moreira, Ronaldo Gabriel, Arsénio Reis, Sara Viana, and Rui Viana
Elsevier BV
BACKGROUND
Pelvic floor muscle training can cure or alleviate stress urinary incontinence. This study aimed to evaluate maximum voluntary contractions of the pelvic floor muscle in sportswomen and verify the association with leg stiffness and muscle power, both maximal and submaximal.
METHODS
The sample consisted of 41 sportswomen between 18 and 42 years of age. Pelvic floor muscle strength was measured by the manometer. The sportswomen were instructed to perform 3 maximum voluntary contractions of the perineum, held for 3 seconds. Maximal and submaximal leg stiffness and muscle power were measured with a force platform, in two conditions: 1st condition was the sub-maximal, double leg hop test, which was performed allowing sportswomen to self-select their preferred frequency and 2nd condition was the maximal double leg hop test, which was performed asking athletes to maximize hop height and minimize contact time on the top of the force platform for 6 consecutive hops.
FINDINGS
Maximal and submaximal leg stiffness values increase with increasing age, weight, height, and body mass index, showing positive and significant (p <0.05) or close correlations. There are strong positive correlations between maximal and submaximal leg stiffness (r = 0.759) and between maximal and submaximal muscle power. Maximum voluntary contractions values decrease with increasing leg stiffness: the correlation is significant with maximal leg stiffness.
INTERPRETATION
Maximum voluntary contractions values decrease with increasing leg stiffness and increase with increasing muscle power values. If the training program aims to increase muscle power, it may also increase maximum voluntary contractions.
Telma Pires, Patrícia Pires, Helena Moreira, Ronaldo Gabriel, Sara Viana, and Rui Viana
Elsevier BV
Telma Filipa Pires, Patricia Maria Pires, Maria Helena Moreira, Ronaldo Eugênio Calçadas Dias Gabriel, Paulo Vicente João, Sara Alexandra Viana, and Rui Antunes Viana
Georg Thieme Verlag KG
T. Pires, P. Pires, H. Moreira, R. Gabriel, Yi-ming Fan, O. Moutinho, S. Viana and Rui Viana
Introduction: One of the functions of the pelvic floor muscles (PFM) is to support the pelvic organs and continence. This continence mechanism tends to change when PFM are exposed to high-impact exercises.
Objetives: To describe the dynamic changes in the pelvic floor (PF) in elite nulliparous athletes.
Methods: Translabial two and three-dimensional ultrasound was used to assess PF anatomy and function in athletes (n=8). This ultrasonography was performed after voiding and in the supine position, using a vaginal probe. The descent of the pelvic organs was assessed on a maximum Valsalva maneuver, whilst the volume datasets were acquired at rest, during maximum voluntary contraction (MVC) and during a Valsalva maneuver. The athletes performed each maneuver at least 3 times, with the most effective being used for evaluation.
Results: The bladder neck descent was 14 mm for the javelin thrower, being the highest value when compared to the remaining participants. Three athletes featured the rectocele (swimming, gymnastics and javelin throw) and 4 participants presented a paravaginal defect (volleyball, horsemanship, javelin throw and printer). The volleyball athlete had the highest value of the levator hiatal area in MVC value.
Conclusions: The athletes present minimal differences in the evaluated parameters. The sample is small to generalize the results, but there is a tendency for athletes of high-impact exercises to have a lower CMV value. Further studies are needed to corroborate these results.
Telma Pires, Patrícia Pires, Helena Moreira, Ronaldo Gabriel, Sara Viana, and Rui Viana
Elsevier BV
OBJECTIVES
To evaluate Maximum Voluntary Contraction (MVC) of the Pelvic Floor Muscles (PFM) in sportswomen, to observe the urinary symptoms and their impact on the Quality of Life (QoL).
DESIGN
Observational cross-sectional study.
SETTING
Gyms and teams in the North of Portugal.
PARTICIPANTS
Sportswomen (n = 197).
MAIN OUTCOME MEASURES
The measurement was performed using a manometer. The sportswomen were instructed to perform 3 MVC of the perineum, held for 3 s. The Kings Health Questionnaire (KHQ) was used to evaluate urinary symptoms and the QoL of the sportswomen.
RESULTS
Age significantly influenced (p < 0.05) the QoL in all domains. An increase in BMI was also significantly associated with a decrease in the QoL. MVC values had a highly significant effect on the overall QoL and all domains, including a reduction in urinary symptoms. The weekly time of physical activity was associated with a better QoL in symptomatology. The practice of high-impact activities decreased the QoL (compared to low-impact activities). The vaginal resting pressure values ranged from 1.60 to 59.80 (24.34 ± 11.00).
CONCLUSIONS
Age, BMI and high-impact sports appear to be the leading factors that promote the onset of SUI, which in turn decrease the QoL in sportswomen. There was a positive association between MVC and weekly time of physical activity in the QoL.
Telma Filipa Pires, Patricia Maria Pires, Maria Helena Moreira, Ronaldo Eugênio Calçadas Dias Gabriel, Paulo Vicente João, Sara Alexandra Viana, and Rui Antunes Viana
Georg Thieme Verlag KG
AbstractThe aim of this study was to investigate the effects of pelvic floor muscles training in elite female volleyball athletes and whether it is an effective therapy for stress urinary incontinence. Fourteen athletes, both continent and incontinent, between 18 and 30 years of age, were randomly assigned to an experimental group or a control group. The experimental group received a protocol for pelvic floor muscle training for 4 months. This consisted of three phases: awareness/stabilization, strength training and power. The control group was not subject to any intervention during the same period. Measures were collected at the initial and final phase for both groups. Maximum voluntary contractions were evaluated with a perineometer, involuntary urine loss with a Pad test and quality of life with the King’s Health Questionnaire. Baseline sociodemographic and anthropometric characteristics were not significantly different. Comparing the two groups, the experimental group improved maximum voluntary pelvic contractions (p<0.001) and reduced urine loss (p=0.025), indicating the existence of significant differences between groups in the variation from the initial and final phases. The percentage of urine loss decreased in the experimental group, from 71.4–42.9%, suggesting that the protocol intervention for 16 weeks may help athletes with stress urinary incontinence.
Rui Viana, Sara Viana, Félix Neto, and Teresa Mascarenhas
Springer Science and Business Media LLC
Introduction and hypothesisUrinary incontinence (UI) in women is a problem of public health with psychological repercussions in various contexts of life. The aim of this study was to adapt and validate the King’s Health Questionnaire (KHQ) in women with UI to Portugal.MethodsFor the adaptation, a multistep forward–back translation protocol was used. The Positive and Negative Affect Schedule and the Satisfaction with Life Scale were used to validate the KHQ. The evaluation of the psychometric properties involved the assessment of validity, reliability, and test–retest stability in 103 women. A factor analysis was conducted to explore the underlying factor structure of KHQ. Inter-domain correlation was calculated for convergent and discriminant validity assessment.ResultsExploratory factor analysis identified three factors “personal limitations and daily life”, “emotions and social relationships” and “urinary symptoms”. Indicators of test–retest stability showed almost perfect agreement with a mean intraclass correlation coefficient (ICC) of 0.937. Internal consistency was found to be high (Cronbach’s alfa > 0.7). Furthermore, the Portuguese version of the KHQ significantly correlates with the Positive and Negative Affect Schedule, supporting construct validity.ConclusionsThe Portuguese version of the KHQ was found to be a valid and reliable measure of the quality of life in women with UI in Portugal, being relevant to both clinical practice and research.
Renato Andrade, Rui Viana, Sara Viana, Thuane da Roza, Teresa Mascarenhas, and R. M. Natal Jorge
Springer International Publishing
To date, several relevant models to the female pelvic support system have been built. Recently, scientific literature has demonstrated biomechanical models as an alternative to better understand and assess the pelvic floor muscles. Biomechanical modelling is a useful approach for investigate the association between pelvic floor defects and stress urinary incontinence or prolapse. Computational models are already a reality and in the future may represent a significant tool for the study of pelvic floor pathophysiology. However, only a few studies used biomechanical models to assess the pelvic floor muscles.
M. Sousa, R. Viana, S. Viana, T. Da Roza, R. Azevedo, M. Araújo, C. Festas, T. Mascarenhas, and R. M. Natal Jorge
Springer International Publishing
Urinary Incontinence (UI) is a prevalent condition among active women, especially in young nulliparous athletes. However, up to now, only a few studies conducted pelvic floor muscles training (PFMT) in athletes with UI. So, the present study evaluated the effect of a comprehensive PFMT protocol on UI symptoms in young nulliparous athletes using biomechanical models. This was a experimental and longitudinal pre and post-test evaluations study with 9 young nulliparous athletes divided in 2 intervention groups: one group had supervision of a physiotherapist and another does not. The participants answered the questionnaires: CONTILIFE to investigate the quality of life, the Self-efficacy Scale of Broome to evaluate the capacity of pelvic floor muscles (PFM) contraction, the IPAQ-SF to quantify the physical activity level and socio-demographic characteristics, to characterize the sample. Additionally, they were clinically assessed by Pad-test to quantify urine loss and by the Oxford Grading Scale and Perineometry to evaluate the strength of PFM contraction. It was used the T-test for two independent samples and the Manny-Whitney test to compare the groups, as well as the Spearman Correlation to correlational analysis. The level of significance was p ≤ 0.05. Seven athletes concluded the 8 weeks-protocol. The protocol shown to be effective in reduce the loss of urine. Further research is necessary to determine the specific PFMT protocol in women that perform exercise.
Thuane Da Roza, Maíta Poli de Araujo, Rui Viana, Sara Viana, Renato Natal Jorge, Kari Bø, and Teresa Mascarenhas
Springer Science and Business Media LLC
Introduction and hypothesisUrinary incontinence (UI) is prevalent in sport students. We hypothesized that pelvic floor muscle training (PFMT) can improve pelvic floor muscle (PFM) strength and symptoms of UI in this group of physically active women.MethodsSixteen sport students with UI participated in this pre-post test pilot study. However, only seven of them, mean age 20.0 ± 0.8 years, completed the 8-week program. Activity level was measured by the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The outcome measure was the International Consultation on Incontinence Questionnaire-Short Form (ICIQ UI SF). PFM strength was measured by manometry as maximum voluntary contraction (MVC).ResultsVaginal resting pressure improved by 17.4 cmH2O (SD 6.7), p = 0.04 and MVC by 16.4 cmH2O (SD 5.8), p = 0.04. ICIQ UI SF score, frequency, and amount of leakage showed statistically significant improvement.ConclusionsPFMT increased PFM strength and reduced frequency and amount of UI episodes in sport students that completed an 8-week PFMT program. Randomized controlled trials are warranted to confirm these results.