Disfunção do assoalho pélvico: qualidade de vida, exercício físico e recomendações

Abstract

Pelvic floor muscle training (PFMT) is mentioned as a promising practice for the treatment of pelvic floor muscle disorders (PFMD), however there is little scientific evidence to prove its effectiveness, as well as other interventions. Considering the hypothesis that PFMD may be related to quality of life (QoL) dissatisfaction in women in the puerperium and the World Health Organization guidelines for the composition of the national public policies guidelines aimed to women are based on scientific evidence , the general objective of the present research was to investigate the importance of recovery of the pelvic floor muscles (PFM) for the QoL of postpartum women. To achieve this objective, this thesis was developed in the Scandinavian (alternative) model, consisting of three studies to meet the specific objectives: 1) to verify whether the guidelines related to the puerperium present in current national public policies have sufficient coverage of health care in the puerperium, specifically on guidelines for recovery from PAM; 2) to analyze the relationship between the perception of the QoL of women in the postpartum period, 45 days after the date of delivery, with the PFMD and associated factors; and 3) to evaluate the effect of three types of training on postpartum PFMD. For objective 1, a documentary search was carried out on the websites of the Ministry of Health and the Government of the State of Paraná, in order to carry out a survey of guidelines related to women's health. For objectives 2 and 3, the target population consisted of women who gave birth at the Materno Infantil University Hospital in the city of Ponta Grossa - a regional reference. A total of 601 women were invited to participate in the survey over a period of three months (June, July and August 2021). From the studies carried out, it can be concluded that: 1) In Brazil, it is necessary to improve access to perineal rehabilitation after childbirth and to screening for pelvic floor disorders, as well as to improve access to information about the symptoms of PFMD and about seeking help; 2) the investigated sample presented a satisfactory perception of QoL, but a negative correlation was found between the perception of QoL and the general score of the PFMD; 3) After 12 weeks of interventions, women who performed training with the Low Pressure Fitness method showed significant recovery in some disorders related to PFMD and in the global score of the Pelvic Floor Bother Questionnaire. However, there was no significant difference between groups