Brazilian Journal of Physical Therapy最新文献

{"title":"Do measures of central sensitization relate to movement-evoked pain in people with chronic low back pain? A longitudinal prospective study","authors":"Lynn Leemans ,&nbsp;Jo Nijs ,&nbsp;Timothy H. Wideman ,&nbsp;Hester den Bandt ,&nbsp;Maarten Moens ,&nbsp;Erika Joos ,&nbsp;David Beckwée","doi":"10.1016/j.bjpt.2024.101138","DOIUrl":"10.1016/j.bjpt.2024.101138","url":null,"abstract":"<div><h3>Background</h3><div>One of the most frequent complaints among people with musculoskeletal pain is pain during physical activity, commonly referred to as movement-evoked pain. It is suggested to be associated with quantitative sensory testing measures of central pain process in individuals with musculoskeletal pain.</div></div><div><h3>Objective</h3><div>To investigate the predictive association between movement-evoked pain scores and measures of central sensitization in patients with chronic nonspecific low back pain. The secondary aim was to determine whether changes in movement-evoked pain scores are associated with changes in measures of central sensitization.</div></div><div><h3>Methods</h3><div>In this longitudinal prospective study, 50 participants with chronic low back pain were included. Pain pressure thresholds, temporal summation of pain, descending pain modulation, and the central sensitization index were assessed as measures of central sensitization. Movement-evoked pain was evaluated using the Back Performance Scale and a 5-minute walk test.</div></div><div><h3>Results</h3><div>Measures of central sensitization, specifically pressure pain thresholds and temporal summation, demonstrated predictive associations with movement-evoked pain measures. In response to treatment, improvements in movement-evoked pain were associated with improvements in measures of central sensitization (i.e., pressure pain thresholds and temporal summation) and improved pressure pain thresholds in the plantar toe significantly predict movement-evoked pain measures experienced during the 5-minute walk test.</div></div><div><h3>Conclusions</h3><div>These results imply that movement-evoked pain is related to processes related to central modulation of pain in patients with nonspecific chronic low back pain.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 6","pages":"Article 101138"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the Brazilian version of the Performance of Upper Limb scale for children and adolescents with Duchenne muscular dystrophy","authors":"Juliana Cardoso ,&nbsp;Giovanna Constantin Silva ,&nbsp;Gabriela Barroso de Queiroz Davoli ,&nbsp;Victória Araújo de Almeida ,&nbsp;Edson Z. Martinez ,&nbsp;Ana Claudia Mattiello-Sverzut","doi":"10.1016/j.bjpt.2024.101118","DOIUrl":"10.1016/j.bjpt.2024.101118","url":null,"abstract":"<div><h3>Background</h3><div>Duchenne muscular dystrophy (DMD) is one of the most common and disabling childhood genetic diseases. The course of DMD involves progressive muscular degeneration and weakness, leading to functional decline. The Performance of the Upper Limb scale (PUL) is a specific instrument designed to assess the upper limb function of patients with DMD.</div></div><div><h3>Objective</h3><div>To adapt the PUL cross-culturally to Brazilian Portuguese (PUL-Br) and assess the convergent validity, structural validity, inter-rater reliability, and internal consistency for Brazilian patients with DMD</div></div><div><h3>Methods</h3><div>The cross-cultural adaptation involved six steps: translation to Brazilian Portuguese, Brazilian Portuguese translation synthesis, back-translation to English, back-translation synthesis, an expert committee review, and a pre-final version test (<em>n</em> = 12). The convergent validity of the PUL-Br was evaluated by examining its correlation to the Motor Function Measure scale (MFM) using 30 patients with DMD. Confirmatory factor analysis was conducted to assess structural validity. Intraclass correlation coefficient (ICC) verified the PUL-Br interrater reliability. Cronbach's alpha was calculated to verify internal consistency.</div></div><div><h3>Results</h3><div>The PUL was cross-culturally adapted to Brazilian Portuguese. A strong and positive correlation was found between the PUL-Br total score and the total score on the MFM (<em>r</em> = 0.83; 95% CI: 0.67, 0.91). The PUL-Br showed a satisfactory fit of the data to the three-factor model, excellent inter-rater reliability (ICC: 0.94), and good internal consistency (Cronbach's: 0.91).</div></div><div><h3>Conclusion</h3><div>The PUL-Br is valid and reliable for assessing the upper limb function of Brazilian patients with DMD.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101118"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does risk stratification with a matched treatment pathway improve clinical outcomes for adults with acute back pain? A systematic review and meta-analysis","authors":"Anthony Frank Chiodo,&nbsp;Melanie Haley","doi":"10.1016/j.bjpt.2024.101116","DOIUrl":"10.1016/j.bjpt.2024.101116","url":null,"abstract":"<div><h3>Background</h3><p>Risk stratification is an approach which has been recommended across a number of international guidelines for the management of back pain.</p></div><div><h3>Objective</h3><p>To assess whether the use of risk stratification with a matched treatment pathway improves clinical outcomes, when compared with usual care or other interventions, in adults with acute back pain.</p></div><div><h3>Methods</h3><p>A comprehensive search was conducted of the databases Medline, Embase, PEDro, CINAHL and Cochrane Library in November 2022. Studies of adults with back pain of less than 3 months’ duration and who had been stratified according to their level of risk of a poor functional outcome and provided with a treatment matched to their level of risk were included. Participants with specific and/or serious spinal pathologies were excluded.</p></div><div><h3>Results</h3><p>Five trials involving 3519 participants were included. Meta-analysis found very-low certainty evidence that the use of a risk stratification approach with matched treatment may lead to a very small reduction in pain levels at 3–6 months compared with usual care (MD -0.62, 95 % CI -0.88, -0.36). These results did not achieve clinical significance. No difference was found for the use of risk stratification compared to usual care for disability (MD -1.52, 95 % CI -4.15, 1.11).</p></div><div><h3>Conclusion</h3><p>The use of risk stratification with matched treatment may be just as worthwhile as usual care for acute back pain, however the evidence is very uncertain. Further high quality research is required to confirm whether risk stratification is a useful approach for this population.</p></div><div><h3>Systematic review registration number</h3><p>CRD42022379987</p></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101116"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy and cut-off points for vaginal manometry to differentiate between weak and strong pelvic floor muscle contraction in pregnant women","authors":"Bianca Manzan Reis ,&nbsp;Jordana Barbosa-Silva ,&nbsp;Susan Armijo-Olivo ,&nbsp;Patricia Driusso","doi":"10.1016/j.bjpt.2024.101115","DOIUrl":"10.1016/j.bjpt.2024.101115","url":null,"abstract":"<div><h3>Background</h3><div>Identifying a weak/strong pelvic floor muscle (PFM) contraction in pregnant women may help prevent and treat dysfunctions during late pregnancy and postpartum.</div></div><div><h3>Objective</h3><div>To determine whether the Peritron™ manometer can accurately differentiate a weak from a strong PFM contraction and the respective cut-offs for its variables in pregnant women.</div></div><div><h3>Methods</h3><div>This is a diagnostic accuracy study. Forty-four women in the third trimester of pregnancy participated (mean±SD age: 29±5 years). The reference test was vaginal palpation, and the index test was vaginal manometry (Peritron™ manometer). Variables assessed by vaginal manometry were rest, maximal voluntary contraction (MVC), MVC average, duration, gradient, area under the curve (AUCm), and contraction speed. The Receiver Operating Curve (AUC/ROC) was used to analyze the data and obtain cut-off points for these variables.</div></div><div><h3>Results</h3><div>Perfect discrimination (AUC=1.00) to differentiate between a weak/strong PFM contraction in pregnant women was observed for peak MCV (cut-off: 40.56 cmH₂O). The MVC average showed excellent discriminative ability (AUC=0.96; cut-off: 30.66 cmH₂O). The gradient variable (AUC=0.85; cut-off: 27.83 cmH₂O/s) and AUCm (AUC=0.86; cut-off: 1315.6 cm²*s) showed a good discriminative ability.</div></div><div><h3>Conclusion</h3><div>The best variables to discriminate between weak/strong PFM contraction in pregnant women using vaginal manometry were peak MVC, MVC average, gradient, and AUCm.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101115"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HealthyTrailsBR – The prevalence of running-related injuries and cramps, and the description of personal and running characteristics in Brazilian trail runners: a cross-sectional study","authors":"Fernanda Rizzo ,&nbsp;Caio Sain Vallio ,&nbsp;Luiz Hespanhol","doi":"10.1016/j.bjpt.2024.101117","DOIUrl":"10.1016/j.bjpt.2024.101117","url":null,"abstract":"<div><h3>Background</h3><p>Physical activity in natural environments, such as trail running, is a way to nurture physical and mental health. However, running has an inherent risk of musculoskeletal injuries.</p></div><div><h3>Objectives</h3><p>To investigate the prevalence of running-related injuries (RRI) and cramps, and to describe the personal and training characteristics of Brazilian trail runners.</p></div><div><h3>Methods</h3><p>A total of 1068 trail runners were included in this observational cross-sectional study. The participants had at least six months of trail running experience. The data were collected between April 2019 and February 2020 through an online and self-reported survey.</p></div><div><h3>Results</h3><p>The point prevalence of RRIs was 39.2 % (95 % credible interval [CrI]: 36.3, 42.1). The body region with the highest point prevalence was the knee. The 12-month period prevalence of RRIs was 69.2 % (95 %CrI: 66.4, 72.0). The body region with the highest 12-month period prevalence was the lower leg. 1- and 12-month period prevalence of cramps was 19.5 % (95 %CrI: 17.1, 21.9) and 36.0 % (95 %CrI: 33.0, 38.8), respectively. Triceps surae was the muscle most affected by cramps.</p></div><div><h3>Conclusions</h3><p>Two in 5 (40 %) trail runners reported being injured at the time of data collection, and about 2 of 3 reported previous RRIs in the last 12 months. The most prevalent injured body regions were the knee and the lower leg. One in 5 trail runners reported cramps in the last month, increasing to 36 % in the last 12 months. Knowing better the characteristics of the population and the burden of health conditions may inform better decisions regarding implementation actions toward trail running practice.</p></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101117"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Fresno test to assess Physical therapists' use of evidence-based practice: measurement properties of the Brazilian-Portuguese short version","authors":"Anderson Martins da Silva ,&nbsp;Dafne Karen da Silva Vieira Rosa ,&nbsp;Rosimeire Simprini Padula","doi":"10.1016/j.bjpt.2024.101112","DOIUrl":"10.1016/j.bjpt.2024.101112","url":null,"abstract":"<div><h3>Background</h3><div>The modified Fresno test is a questionnaire developed to evaluate Evidence-Based Practice among physical therapists. A previous study has indicated that a shorter version with 9 items would be more appropriate for Brazilian physical therapists.</div></div><div><h3>Objectives</h3><div>To test the measurement properties of the modified Fresno test - Brazilian-Portuguese short version.</div></div><div><h3>Methods</h3><div>To analyze the reliability of the modified Fresno test - Brazilian-Portuguese short version by two raters (intra and inter-rater) in a sample of 133 physical therapists. The intraclass correlation coefficient (ICC_2,1) and standard error of measurement (SEM) was used to assess the test-retest reliability. Internal consistency was tested using the Cronbach's alpha coefficient. An expert committee analyzed content validity using the content validity index (CVI). Confirmatory factor analysis (CFA) using the principal components method was used to assess construct validity. Responsiveness was estimated using effect size, and ceiling and floor effects were also investigated.</div></div><div><h3>Results</h3><div>Inter-rater and intra-rater reliability were, respectively: ICC= 0.93 (95 % CI 0.91, 0.95); rater 1 - ICC= 0.95 (95 % CI 0.94, 0.97); rater 2 - ICC= 0.98 (95 % CI 0.98, 0.99). The agreement was very good (values ≤ 5 %). Internal consistency was good for most instrument items (≥ 0.80). The CVI showed agreement among the expert committee members (0.96). The Cronbach's alpha coefficients calculated for the corrected item total showed values greater than 0.40. In the CFA, the “model 2” showed acceptable indices (≥ 0.90). Responsiveness was classified as very small. No ceiling and floor effects.</div></div><div><h3>Conclusion</h3><div>The Fresno Modified Test - Brazilian-Portuguese short version has good to excellent reliability. CFA showed that the fit indices were adequate to be used in the population of interest.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101112"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of nutritional factors on the road toward multimodal lifestyle interventions for persistent pain","authors":"Ömer Elma ,&nbsp;Jo Nijs ,&nbsp;Anneleen Malfliet","doi":"10.1016/j.bjpt.2024.101119","DOIUrl":"10.1016/j.bjpt.2024.101119","url":null,"abstract":"","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101119"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142151590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I feel more confident”: a mixed methods evaluation of the influence of Good Life with osteoarthritis Denmark (GLA:D®) on physical activity participation, capability, barriers, and facilitators in people with knee osteoarthritis","authors":"Emily C. Bell ,&nbsp;Paul O'Halloran ,&nbsp;Marcella F. Pazzinatto ,&nbsp;Jason A. Wallis ,&nbsp;Kay M. Crossley ,&nbsp;Joanne L. Kemp ,&nbsp;Zuzana Perraton ,&nbsp;Christian J. Barton","doi":"10.1016/j.bjpt.2024.101113","DOIUrl":"10.1016/j.bjpt.2024.101113","url":null,"abstract":"<div><h3>Background</h3><p>A mixed methods study which aimed to evaluate the influence of Good Life with osteoArthritis Denmark (GLA:D®) on physical activity participation, including perceived capability, barriers, and facilitators in people with knee osteoarthritis.</p></div><div><h3>Objective</h3><p>Quantify changes in physical activity participation at 3- and 12-months for people with knee osteoarthritis who participated in an education and exercise-therapy program (GLA:D®).</p></div><div><h3>Methods</h3><p>A mixed-methods study involving 44 participants with knee osteoarthritis who completed GLA:D®. Guided by the Theoretical Domains Framework, 19 were interviewed, with transcripts analysed using reflexive thematic analysis. University of California Los Angeles physical activity scores were dichotomised as ‘more’ (≥7) or ‘less’ active (≤6), and compared between baseline and 3- and 12-months using McNemar's test. Motivation and confidence to exercise (0–10 scale); fear of knee joint damage with exercise (yes/no); and Knee Osteoarthritis Outcome Scores (KOOS) were evaluated.</p></div><div><h3>Results</h3><p>Four overarching themes were identified: prior to GLA:D® 1) fear of knee joint damage, and scarcity of exercise and physical activity information prior to GLA:D®; and following GLA:D® 2) varied exercise-therapy and physical activity participation; 3) facilitators including reduced fear of knee damage, increased confidence, routine, strategies, and support; and 4) ongoing barriers including persistent knee pain, comorbidities, cost, and lack of opportunity and motivation. There was no difference in the proportion of ‘more’ active participants between baseline (41%) and at 3-months (37%, <em>p</em> = 0.774) or 12-months (35%, <em>p</em> = 0.375). The proportion with fear of damage reduced from baseline (50%) to 3-months (5%) and 12-months (21%). Self-reported motivation (9.1/10) and confidence (9.1/10) to exercise at 3-months were high, and all KOOS subscales improved from baseline to 3-months (effect sizes = 0.41–0.58) and 12-months (effect sizes = 0.29–0.66).</p></div><div><h3>Conclusion</h3><p>Varied and often inadequate physical activity participation following GLA:D® indicates more targeted interventions to address ongoing barriers may be required.</p></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101113"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1413355524005239/pdfft?md5=0520082e9e4aa55e0ce910aadbaabc9c&pid=1-s2.0-S1413355524005239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142242338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replacing sedentary time or light physical activity with moderate physical activity is associated with a lower prevalence of back pain: a cross-sectional study using isotemporal analysis","authors":"Crystian B.S. Oliveira ,&nbsp;Tatiana M Damato ,&nbsp;William R. Tebar ,&nbsp;Guilherme H.D. Grande ,&nbsp;Rubens V.C. Vidal ,&nbsp;Gerson Ferrari ,&nbsp;Bruna T.C. Saraiva ,&nbsp;Diego G.D. Christofaro","doi":"10.1016/j.bjpt.2024.101123","DOIUrl":"10.1016/j.bjpt.2024.101123","url":null,"abstract":"<div><h3>Background</h3><div>Evidence shows that lack of physical activity and sedentary time are associated with higher prevalence of low back pain (LBP).</div></div><div><h3>Objective</h3><div>To investigate the association between replacing sedentary time and light physical activity with a higher physical activity level with the prevalence of LBP.</div></div><div><h3>Methods</h3><div>Two hundred and sixty-six individuals from a city in southeastern Brazil were recruited to this cross-sectional study. Sedentary behavior and physical activity level were evaluated using an ActiGraph GT3X tri-axial accelerometer during 7 days. The prevalence of LBP was assessed using the Nordic questionnaire. Isotemporal substitution using logistic regression analyses were performed to investigate the association between replacing an activity with another in the prevalence of LBP.</div></div><div><h3>Results</h3><div>Replacing time spent in sedentary behavior with moderate physical activity slightly reduced the prevalence of LBP (odds ratio [OR]= 0.97; 95% CI: 0.95, 0.98). In addition, replacing time spent in light physical activity with moderate physical activity also slightly reduced the prevalence of LBP (OR= 0.97; 95% CI: 0.95, 0.98). There was no association for replacing sedentary time and light or moderate physical activity with vigorous physical activity on the prevalence of LBP.</div></div><div><h3>Conclusions</h3><div>The results suggest a small protective effect for LBP when replacing time in sedentary activities or light physical activity with moderate physical activity.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101123"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic floor muscle training for urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life after hysterectomy: a systematic review with meta-analyses","authors":"Néville Ferreira Fachini de Oliveira,&nbsp;Cintia Helena Santuzzi,&nbsp;Thayara Viana da Conceição,&nbsp;Júlia Martins Vasconcellos Freitas,&nbsp;Fernanda Mayrink Gonçalves Liberato,&nbsp;Lucas Rodrigues Nascimento","doi":"10.1016/j.bjpt.2024.101122","DOIUrl":"10.1016/j.bjpt.2024.101122","url":null,"abstract":"<div><h3>Background</h3><div>After hysterectomy, women could experience pelvic floor dysfunction and negative impact on quality of life, which could be improved by pelvic floor muscle training.</div></div><div><h3>Objective</h3><div>To investigate effects of pelvic floor muscle training on urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life after hysterectomy.</div></div><div><h3>Methods</h3><div>Systematic review with meta-analyses of randomized controlled trials. Trials with pelvic floor muscle training in women after hysterectomy were included. The outcomes measures were urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life. Quality of evidence was assessed by adopting the GRADE approach.</div></div><div><h3>Results</h3><div>Six trials, involving 776 participants, were included. The mean PEDro score of trials was 5.5. Moderate-quality evidence suggested that pelvic floor muscle training improves sexual function by 5 points (95% CI: 4, 6) on the Female Sexual Function Index, compared with no intervention. It might affect strength (SMD 0.5; 95% CI: −0.4, 1.3), quality of life (SMD 0.5 points out of 108, 95% CI: −0.1, 0.9), urinary symptoms (RD −0.02; 95% CI: −0.06, 0.1); however, the estimates were too imprecise. In addition, it produces no or negligible effects on vaginal prolapse (RD 0; 95% CI: −0.1, 0.1). Long-term effects remain uncertain.</div></div><div><h3>Conclusion</h3><div>This systematic review provides moderate-quality evidence that pelvic floor muscle training is effective for improving women's sexual function after hysterectomy, in comparison with no intervention. Benefits on urinary symptoms, pelvic floor muscle strength, quality of life, and vaginal prolapse remains unclear. Also, the effects beyond the intervention period remains uncertain.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 5","pages":"Article 101122"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}