This study performed a systematic review of game therapy effects on urinary incontinence patients. Eleven databases (PubMed, SCOPUS, SciELO, LILACS, Web of Science, EMBASE, Cochrane library, LIVIVO, ...OpenGrey, OpenThesis, and OATD) were used as research sources. The search was conducted in January 2021 with the following keywords: urinary incontinence, urinary stress incontinence, pelvic floor muscle, pelvic floor training, virtual reality, game therapy, virtual reality exposure, and virtual reality therapy. The review included only clinical studies using game therapy for treating urinary incontinence in women without restrictions on language, year, and publication status. Only three studies fulfilled the eligibility criteria. The extracted data comprised sample characteristics (the number of patients in each study and average age) and treatment characteristics (game type, associated therapies, treatment duration, evaluated objectives, and result-measuring methods). The methodological quality of the articles showed a low risk of bias. One-hour pad test values decreased in all studies, and ICIQ-SF scores reduced in two articles. One study reported treatment adherence (92%), and another showed neuropsychological index improvements. The reduction of urinary symptoms was similar between the group associating game therapy with treatment and the group using only conventional pelvic floor muscle training. Game therapy, as a resource of pelvic floor muscle training, seems beneficial to urinary incontinence, including decreased urinary symptoms, lower one-hour pad test scores, and neuropsychological index improvements.
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.
The Health-Related Quality of Life Questionnaire for Nausea and Vomiting of Pregnancy (NVPQOL) is a validated questionnaire assessing quality of life among pregnant women with nausea and vomiting.
To ...translate, cross-culturally adapt and evaluate the reliability of the NVPQOL.
Observational cross-sectional study developed in a public university in Brazil.
The translation, synthesis of translations, back-translation, expert committee, pre-testing and validation were carried out, resulting in a Portuguese-language version. The internal consistency, intra-rater and test-retest reliability and correlation between the total score of the Portuguese-language version of the NVPQOL and the domains of the World Health Organization Quality of Life-bref questionnaire were considered in the data analysis.
The instrument went through the process with testing on 104 pregnant women. Strong internal consistency (Cronbach's α: 0.95), strong intra-rater and test-retest reliability (P < 0.0; intraclass correlation coefficient: 0.89; confidence interval: 0.791-0.945) and strong correlation between the total score of the Portuguese-language version of the NVPQOL and the physical health domain of the World Health Organization Quality of Life-bref questionnaire (P < 0.01; R = -0.8) were observed.
The NVPQOL was translated, cross-culturally adapted and validated for the Portuguese language with satisfactory psychometric properties for assessing quality of life, especially in relation to physical health, among pregnant women with symptoms of nausea and vomiting in the first trimester of pregnancy.
several studies have been investigated co-activation can enhance the effectveness of PFM training protocols allowing preventive and therapeutic goals in pelvic floor dysfunctions. The objective of ...the present study was to investigate if an abdominal-pelvic protocol of training (APT) using gametherapy would allow co-activation of PFM and transversus abdominis/oblique internal (TrA/OI) muscles.
Twenty-five nulliparous, continent, young females, with median age 24.76 (±3.76) years were evaluated using digital palpation (DP) of PFM and surfasse electromyography of PFM and TrA/OI simultaneously, during maximal voluntary contraction (MVC), alternating PFM and TrA/OI contraction requests. All women participated on a supervised program of APT using gametherapy, that included exercises of pelvic mobilization associated to contraction of TrA/OI muscles oriented by virtual games, for 30 minutes, three times a week, in a total of 10 sessions. Electromyographic data were processed and analyzed by ANOVA - analysis of variance.
When MVC of TrA/OI was solicited, it was observed simultaneous increase of electromyographic activity of PFM (p=0.001) following ATP. However, EMG activity did not change significantly during MVC of PFM.
Training using gametherapy allowed better co-activation of pelvic floor muscles in response to contraction of TrA, in young nulliparous and continent women.
The objective of this work was to select soybean genotypes with high yield, adaptability and stability in different sowing seasons in the Cerrado-Pantanal ecotone region using the MHPRVG method ...(harmonic mean of the relative performance of genetic values). We evaluated 10 soybean genotypes at two sowing seasons in Aquidauana/MS in the agricultural year 2014/2015. At maturation, the following agronomic traits were evaluated: plant height (PH), first pod height (FPH), number of branches per plant (NB), number of pods per plant (NP), number of grains per pod (NGP), mass of hundred grains (MHG) and yield grain (YIE). Likelihood ratio test detected significant genotype x seasons interaction only for grain yield. The genotypes AS3730, 97R73 and SYN9070 showed high adaptability and can be growing in both sowing seasons in the Cerrado/Pantanal ecotone. The genotypes 97R21 and B4184 have high phenotypic stability and are indicated for growing in later sowing season.
RESUMO Para o ótimo controle postural, o centro de massa (COM) do corpo é uma variável que se projeta verticalmente entre os pés, dentro de uma base de suporte. Este estudo teve por objetivo avaliar ...a confiabilidade inter e intra-avaliadores da projeção do COM na base de sustentação, mensurada com auxílio do Software de Avaliação Postural (SAPO). Cinquenta e sete voluntárias foram avaliadas e todas foram submetidas ao registro fotográfico nas vistas anterior, lateral direita e esquerda, no mesmo instante temporal. As imagens foram entregues a dois examinadores, os quais utilizaram o SAPO. Para a análise estatística, foi utilizado o coeficiente de correlação intraclasse (ICC) e, para estimar a mínima mudança detectável (MMD), foi utilizado o erro padrão (EP). Os resultados demonstraram excelentes níveis de confiabilidade interexaminador e intraexaminador para assimetrias nos planos frontal, sagital e para a projeção do centro de gravidade no plano frontal e lateral (ICC>0,90; 95%IC>0,95; MDD entre 2,16 - 4,87). Os resultados do estudo demonstraram que a análise do COM obtida por meio do SAPO apresentou boa confiabilidade nas análises inter e intra-avaliadores.
The increase of the intensity of urinary symptoms in late pregnancy and postpartum has been well documented by several authors, but their causes remain uncertain, partly because of its probable ...multifactor origin. There are also controversies whether the etiology of lower urinary tract symptoms during pregnancy is the same as postpartum and whether the method of delivery could influence the risk of onset of urinary symptoms. This study aimed to evaluate the urinary symptoms triggered during pregnancy and its evolution in the late puerperium, correlating them with the delivery method.
A longitudinal study was conducted, which included 75 primigravidae women, classified according to method of delivery as: (VD) vaginal delivery with right mediolateral episiotomy (n = 28); (CS) elective caesarean section (n = 26); and (EC) emergency caesarean section (n = 21). Urinary symptoms were assessed in the last trimester of pregnancy and at 45 days (± 10) of puerperium with validated versions for Portuguese language of the following questionnaires: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB).
It was observed that frequency, urgency, nocturia and urge incontinence, triggered during pregnancy, decreased significantly in the postpartum period, regardless of the delivery method (p = 0.0001). However, symptoms related to urinary loss due to stress persisted after vaginal delivery (p = 0.0001).
Urgency, frequency and nocturia triggered during pregnancy tend to disappear in the late postpartum period, regardless of the delivery method, but the symptoms related to urinary loss due to stress tend to persist in late postpartum period after vaginal delivery.
Introduction and hypothesis
Our objective was to evaluate the effectiveness of pelvic floor muscle training (PFMT) in reducing overactive bladder (OAB) symptoms in women.
Methods
Searches were ...performed at MEDLINE, PubMed, Physiotherapy Evidence Database (PEDro), Scielo, and Central Cochrane Library PubMed until January 2017. Controlled trials were researched by two independent reviewers. Eligible studies were restricted to random and controlled clinical trials that investigated the effectiveness of PFMT in decreasing OAB symptoms. Qualitative methodology was evaluated using the PEDro scale. Data was analyzed and interpreted qualitatively.
Results
The final search retrieved eight studies (
n
= 1161 women with urgency symptoms), which were published between 2002 and 2016. The methodological scores varied between 4 and 7 in the PEDro scale. PFMT, with the objective of controlling urgent micturition, demonstrated improvements in quality of life in women with OAB. Most data in this revision came from small- to moderate-sized trials, with different and inconsistent outcome measures, which could have impacted the end results.
Conclusions
The literature regarding the effectiveness of PFMT in OAB remains heterogeneous and inconclusive.
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