During pregnancy, many changes in the musculoskeletal system and pregnancy-related disorders affect posture and postural stability. Pregnancy-related pelvic girdle pain (PPGP) is a common disorder in ...pregnancy; the cause remains unknown. The purpose of the present study was to determine if PPGP affects static postural stability and its relation to the stage of pregnancy.
Sixty-three pregnant women between the ages of 18 and 45 and between the 12th and 38th weeks of gestation were included in the study. They were divided into four groups according on the trimester and the presence of PPGP. Static balance was assessed using a force plate on firm and compliant surfaces with eyes open and closed.
Pregnant women with PPGP had significantly (p < 0.05) greater centre-of-pressure velocity and sway area compared to pregnant women without PPGP, especially in the third trimester of pregnancy. In the second trimester, only two significant differences in COP parameters were observed between pregnant women with and without PPGP. Pregnant women in the third trimester of pregnancy had significantly (p < 0.05) greater centre-of-pressure velocity and larger postural sway area compared to pregnant women in the second trimester of pregnancy, regardless of PPGP.
Pregnant women with PPGP had poorer static stability when compared to pregnant women without pain, especially in the third trimester of pregnancy. The cause could be found in the poorer ability to stabilise the trunk and pelvis, poorer proprioception, and issues with automatic movement patterns.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Stress urinary incontinence (SUI) is a common complaint in women after childbirth. It affects their quality of life and sexual satisfaction and is one of the major reasons for gynaecological surgery. ...There is a need for effective non-invasive treatment alternatives. The aim of this study was to evaluate the efficacy and safety of non-ablative Er:YAG laser therapy in the treatment of SUI and improvement of sexual gratification in parous women.
114 premenopausal parous women with SUI were randomized in two groups of 57 women; a laser intervention group and sham group. Both groups were treated according to the IncontiLase® clinical treatment protocol for SUI with non-ablative thermal-only Er:YAG laser, except that there was no energy output when treating the sham group. Patients were blinded to the allocation. At baseline and 3 months after treatment patients were clinically examined, answered questionnaires for SUI severity and sexual function assessment and their pelvic floor muscle (PFM) function was assessed with perineometry. Validated International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) was used as the primary outcome measure. The Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and The Female Sexual Function Index (FSFI) were used to assess the sexual function. Patients were monitored for discomfort and side-effects during treatment and follow-up period.
3 months after treatment the ICIQ-UI SF (p < 0.001), PISQ-12 (p = 0.014) and FSFI (p = 0.025) scores were significantly more improved in the laser group than in the sham control group. All perineometry variables improved in the laser group after treatment; duration and maximum pressure had statistically significantly better improvement than the sham group, whereas average pressure did not. 21% of laser treated patients were dry (ICIQ-UI SF = 0) at follow up compared to only 4% of the sham control patients. No serious adverse effects were observed or reported. The treatment was well tolerated by patients.
The non-ablative Er:YAG laser therapy improves the impact of SUI symptoms on quality of life and sexual function in premenopausal parous women significantly better than placebo. It provides a promising minimally-invasive safe treatment alternative for SUI.
Work-related musculoskeletal (MS) disorders are considered one of the most frequent occupational diseases among dental workers. Dental work consists of static, demanding tasks that involve repeated ...gripping of small-sized instruments. The purpose of this study was to investigate the prevalence of MS pain, the areas of pain, and the risk factors for MS pain in dental workers. A self-administrated questionnaire was used as a data collection instrument for dental workers who voluntarily responded to the invitation. To determine the prevalence and severity location of MS pain, the Cornell Musculoskeletal Discomfort Questionnaire was administered among 87 dental workers, with a total of 79.8%, who reported at least one MS complaint. MS pain occurred in 82.6% of general dentists, 75.0% of dental specialists, 66.7% of dental assistants, and 33.3% of dental technicians. Pain most frequently occurred in the neck (60.7%), upper back (52.4%), right shoulder (44.0%), lower back (41.7%), hips/buttocks (29.8%), and the right wrist (23.8%). The prevalence of pain among dental workers could be reduced by ergonomic working environment, regular breaks, maintenance of health, and performing specific exercises designed to dental workers.
Background: Obesity during pregnancy represents a global problem and is a major risk factor for complications during pregnancy and labour. Emerging evidence suggests that physical activity during ...pregnancy might be beneficial for both maternal and foetal health without side effects. The purpose of this systematic review was to review trials evaluating the effect of physical activity on maternal and foetal health in obese pregnant women. Methods: PRISMA guidelines were followed. We searched for randomized controlled trials published until June 2018 on the PubMed, PEDro and CENTRAL databases. We included articles that had a well described physical activity intervention and studied obese pregnant women with BMI > 30 kg/m2.Results: Ten articles were included in the review. All articles included a physical activity intervention, seven articles included also a dietary intervention. Four articles included a pedometer-based intervention, six articles opted for a supervised physical activity intervention. Physical activity with or without dietary intervention had no effect on lowering the risk for gestational diabetes mellitus or improving neonatal or other maternal outcomes. There were mixed results in gestational weight gain and mode of delivery. Conclusion: We can conclude that physical activity during pregnancy has mixed results on maternal and foetal health in obese pregnant women. There is no evidence from randomized controlled trials that PA during pregnancy in obese women improves maternal or neonatal outcomes, and therefore no clear statements on beneficial effects of PA in this population can currently be made.
Background: Vulvodynia has been dened as vulvar discomfort, most oen described as burning pain, occurring in the absence of relevant ndings or a specic, clinically identiable neurologic disorder. ...Vulvodynia is a genital syndrome of multi-causal origin and requires a team approach. The purpose of the case report of provoked vulvodynia is to show the efficacy of individualized, multifaceted and multidisciplinary therapeutic team approach used by a gynaecologist with special knowledge of sexology and a physiotherapist specialising in the treatment of pelvic oor dysfunction. Case report: A 35-year old patient presented with a complaint of genital itching and consequently burning pain which rst occurred during sexual intercourse one year ago. Aerwards a gynaecologist with special knowledge of sexology performed a biopsychosocial assessment, extended gynaecological examination and psychoeducation. Provoked vulvodynia was diagnosed. Aerwards the patient was assessed by a physiotherapist specialising in the treatment of pelvic oor dysfunction, and treated with TENS. Female Sexual Function Index questionnaire and the visual analogue scale before and after the team approach treatment were used to assess the effectiveness of treatment. Conclusion: In our case, individualized multi-faceted and multidisciplinary therapeutic ap proach proved to be a good choice for treating genital syndrome of provoked vulvodynia of multi-causal origin.
Background: The purpose of the research was to determine the prevalence and location of diastasis recti abdominis muscle (DRA) during pregnancy and puerperium in women in the Ljubljana maternity ...hospital. Methods: The study sample included sixty randomly selected women; forty-five pregnant and postpartum women were recruited from the Ljubljana Maternity Hospital, and fifteen non-pregnant women from the larger Ljubljana area as a control group. All women were examined for the presence or absence of diastasis recti abdominis muscle along with the most and least likely location along the white lines. The measurements were performed by the finger-width method. Results: The findings indicate that the diastasis recti abdominis muscle increases with the progression of pregnancy. In the case of non-pregnant women, the diastasis is not present. The presence of DRA was first observed in the second trimester of pregnancy (9.5 %) and was most common in the third trimester (52.4 %). After birth, the incidence decreased (38.1 %). The majority of diastasis recti abdominis cases were observed in the umbilical area (52.6 %) in the third trimester. In the puerperium group three days after childbirth the diastasis below the umbilicus was most common (60.0 %) and slightly less common above the umbilicus (53.8 %). Conclusion: Diastasis recti abdominis muscle during pregnancy and after childbirth is a common condition. It is therefore recommended that all women should be timely examined for the presence of DRA before and after birth along the linea alba to start timely and adequate physiotherapy treatment. Health professionals as well as sports teachers and coaches who work with pregnant and puerperium women should be educated/trained in the field of testing and treatment of diastasis recti abdominis muscle.
Uvod: Kot posledica pomanjkanja estrogenov se po menopavzi pojavi večja verjetnost nastanka kardiovaskularnih bolezni, osteoporoze, depresije in urinske inkontinence. Namen članka je pregled ...literature in predstavitev rezultatov raziskav, ki so proučevale vpliv telesne dejavnosti na kardiovaskularni in vazomotorni sistem, na urogenitalno in vezivno tkivo ter na duševno zdravje pri ženskah v pomenopavzi.
Metode: Iskanje strokovne in znanstvene literature je bilo opravljeno s pomočjo bibliografskih baz podatkov COBISS.SI, PubMed, CINAHL, EMBASE in registra študij Cochrane Library. Iskanje je bilo omejeno na besedila, dostopna na spletu, v slovenščini ali angleščini (ali drugih jezikih, če so članki vsebovali izvlečke v angleščini), izdana od januarja 2000 do decembra 2012. Glede na vključitvene in izključitvene kriterije je bilo v pregled zajetih enajst randomiziranih kontroliranih raziskav, ki so bile glede na tematiko razdeljene v pet skupin.
Rezultati: Pokazal se je pozitiven vpliv redne telesne dejavnosti na izražanje simptomov, ki so posledica pomanjkanja estrogena v telesu žensk v pomenopavzi. Redna telesna dejavnost ima najboljši vpliv na kardiovaskularni sistem, mentalno zdravje, urinsko inkontinenco in osteoporozo, glede njenega vpliva na izražanje vazomotornih simptomov pa so mnenja deljena.
Diskusija in zaključek: Najkoristnejša telesna dejavnost za zdravje žensk v pomenopavzi je aerobna vadba zmerne intenzitete. Potrebne so nadaljnje raziskave o vplivu telesne dejavnosti na izražanje vazomotornih simptomov pri ženskah v pomenopavzi.
Background: Pregnancy-related pelvic girdle pain (PGP) refers to the pain in the lumbosacral region, the sacroiliac joints and the symphysis pubis joint. The results of the high methodological ...quality studies indicate that the point prevalence of pregnant women suffering from PGP is about 20 %. Pregnancy-related PGP requires a comprehensive physiotherapy assessment in order to make or confirm a diagnosis, plan the treatment and evaluate the patient’s condi- tion. Physiotherapy assessment includes clinical diagnostic tests which should satisfy the criteria of safety, feasibility, reliability, sensitivity, specificity and validity. The aim of the present paper was to systematically review the literature on clinical diagnostic tests of PGP in order to determine which clinical tests meet the necessary criteria and are appropriate for clinical examination of PGP in pregnancy and postpartum. Methods: PubMed, Cinahl, Embase, Index Medicus databases and the Cochrane controlled trials reg- ister from 1980 to 2008 were searched using the key words, pregnancy/pelvic girdle pain, pregnancy/clinical tests/sacroiliac joint/symphysis pubis. Only the articles/texts in English and Slovene were reviewed unless translated abstract was available. Additional manual searches of the reference lists in books and review articles were undertaken. Along with the randomized clinical studies the literature search encompassed also the basic studies. Results: Nine studies evaluating the tests for clinical examination of the pregnancy-related PGP met the criteria for inclusion in this review. The studies evaluated and analysed six provocation tests for the sacroiliac joint, namely, the Posterior pelvic pain provocation test (P4), Patrick’s Faber test, palpation of the long dorsal ligament, compression test, separation test, Menell’s test as well as two provocation tests for the symphysis pubis joint (pain palpation and a modified Trendelenburg test) and one functional pelvic girdle test to assess the impairment (Active Straight Leg Raise –ASRL). The tests exemplifying the highest level of specificity and reliability to identify the pain in the sacroiliac joint proved to be the Posterior pelvic pain provocation test, Patrick’s Faber test and the palpation of the long dorsal ligament of the sacroiliac joint. According to the studies, the palpation and a modified Trendelenburg test are most appropriate to identify the pain, abnormalities and symphysis pubis asymmetries. The active straight leg raise is recommended as a functional test of the pelvic girdle. Conclusions: PGP can be diagnosed by pain provocation tests and pain palpation tests. Most of the evalu- ated tests have a very high specificity indicating that, if negative, it is likely that a patient does not suffer from pain in the pelvic girdle during pregnancy and in the postpartum period. The sensitivity is, however, lower. It is therefore recommended to perform all the tests, not to rule out PGP, if one test is negative. All the recommended tests are simple to carry out and appropriate for clinical examination of pregnancy-related PGP.
Research Question (RQ): FGM represents a global concern as 63 million more girls could be subjected to FGM by 2050. It is a deeply embedded cultural tradition that holds a symbolic meaning in ...numerous communities and is practiced in rural and urban areas. Purpose: The objective of this paper was to review the current literature on female genital mutilation consequences, to describe and critically assess the theoretical and methodological approaches to treatment options and to describe and assess different methods that aim to stop or reduce the continuation od FGM. Method: We carried out a literature review of articles published in the last 10 years. Included articles studied consequences following FGM, treatment options and different methods to stop or reduce the continuation of FGM. Literature search was conducted on the following databases PubMed, PEDro, Cochrane database, CINAHL and Medline. Results: Globally the prevalence is declining, as many actions from legal to community based programmes are being proposed. There are many known consequences that can be divided in to two groups: short and long term. Treatment options are t well documented in the literature, but published studies are of poor quality. Nevertheless there are many treatment options and guidelines on how to treat women with FGM. Organization: Health care professional should be well informed and sensitive to properly treat women with FGM. They should also inform women about possible consequences and legal aspects. Society: Society should be informed about this procedure and should encourage open communication within the society, especially between men and women. Originality: This article offers a new and recent prospective of FGM, consequences and treatment options as well as what we can do to stop this practice. Limitations / further research: Limitations of this review include the risk of bias, because it is not possible to identify and retrieve all studies. Future research should be of better quality and should focus especially on treatment options.
Properly selected and prescribed physical activity during pregnancy has a favorable eect on the health of pregnant women and the fetus, and is excellent preparation for childbirth. Absolute and ...relative contraindications to exercise during pregnancy are well dened, as well as the warning signs to terminate exercise while pregnant. Knowledge of these is essential for physically active pregnant women and for exercise professionals that work with pregnant women. Pregnant women should be moderately physically active every day of the week for at least 30 minutes. The term moderate is thoroughly and clearly dened in the guidelines. Resistance exercises during pregnancy are safe but it is advised to use light loads and a large number of repetitions (e.g. 1520 repetitions). Strength exercises for the pelvic oor muscles deserve a special place during pregnancy. Appropriate forms of physical activity for pregnant women are walking and jogging, swimming and aquatic exercise, cycling, Pilates and yoga, aerobics, tness and cross-country skiing. Certain forms of physical activity require special adjustments (alpine skiing, ice skating and rollerblading, racket sports, team ball games, horseback riding and scuba diving).
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