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Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2023.tde-22082023-114135
Document
Author
Full name
Claudia Rosenblatt Hacad
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Tanaka, Clarice (President)
Lucon, Marcos
Schmitt, Ana Carolina Basso
Toledo, Luis Gustavo Morato de
Title in Portuguese
Os efeitos das intervenções fisioterapêuticas na dor e nos sintomas urinários em mulheres com síndrome da dor vesical: estudo randomizado controlado
Keywords in Portuguese
Biofeedback
Cistite intersticial
Dor pélvica
Estimulação elétrica nervosa transcutânea
Fisioterapia
Terapia manual
Abstract in Portuguese
Objetivos: verificar os efeitos do biofeedback (BF) e da terapia manual (TM) associada a eletroestimulação transcutânea (TENS) ou exercícios posturais (EP) no tratamento da síndrome da dor vesical (SDV) em mulheres em relação à dor e aos sintomas urinários. Métodos: um estudo randomizado controlado paralelo foi conduzido em mulheres com diagnóstico de SDV de acordo com os critérios clínicos do National Institute of Health (NIH). Duas fisioterapeutas especializadas aplicaram questionários demográficos e questionários validados de dor perineal e suprapúbica (EVA), de sintomas e problemas urinários (ICSI e ICPI) e função sexual (FSFI) e foi realizada uma avaliação física para identificar pontos gatilho miofascial. 31 mulheres, idade média de 51,8 ± 10,9 anos, foram randomizadas em 3 grupos de tratamento que consistiu em 10 sessões, 1 x/semana, de BF e TM (Grupo Convencional); BF, TM e TENS (Grupo TENS) e BF, TM e EP (Grupo Postural). Resultados: o Grupo Postural melhorou a dor perineal e suprapúbica após o tratamento (p < 0,001 e p = 0,001, respectivamente) e a melhora da dor suprapúbica permaneceu persistente em 3 meses de seguimento (p = 0,001). O Grupo Postural melhorou os sintomas e problemas urinários após o tratamento (p < 0,001 e p = 0,005, respectivamente) e durante o seguimento de 3 meses (p < 0,001 e p = 0,001). Conclusão: biofeedback e terapia manual associados aos exercícios posturais mostrou uma melhora significante da dor perineal e suprapúbica e dos sintomas urinários após tratamento e durante o seguimento. Ambos os resultados sugerem um possível papel para o uso dessa técnica fisioterapêutica para tratar pacientes com SDV. Um seguimento mais prolongado e um número maior de pacientes são necessários para confirmar essas conclusões
Title in English
The effects of physical therapy interventions on pain and urinary symptoms in women with bladder pain syndrome: a randomized controlled trial
Keywords in English
Biofeedback
Cystitis interstitial
Manual therapy
Pelvic pain
Physiotherapy
Transcutaneous electric nerve stimulation
Abstract in English
Aims: to verify the effects of biofeedback (BF) and manual therapy (MT) associated with transcutaneous electrical nerve stimulation (TENS) or postural exercises (PE) in the treatment of bladder pain syndrome (BPS) in women regarding pain and urinary symptoms. Methods: a parallelrandomized controlled trial was conducted in BPS patients diagnosed according to NIH clinical criteria. Two specialized physiotherapists applied demographic and validated questionnaires of perineal and suprapubic pain (VAS), urinary symptoms and problems (ICSI and ICPI) and sexual function (FSFI) and a physical assessment was made to identify myofascial trigger points. Thirty-one women, mean age 51.8 ± 10.9 were randomized in three groups of treatment consisting of ten weekly sessions of BF and MT (Conventional group); BF, MT, and TENS (TENS group); and BF, MT, and PE (Postural group). Results: postural group improved perineal and suprapubic pain after treatment (p < 0.001 and p = 0.001, respectively), and the suprapubic pain improvement remained persistent at 3 months of follow up (p = 0.001). Postural group improved urinary symptoms and problems after treatment (p < 0.001 and p = 0.005, respectively) and during follow up (p< 0.001 and p = 0.001). Conclusions: biofeedback and manual therapy associated with postural exercises showed a significant improvement in perineal and suprapubic pain and urinary symptoms after treatment and during follow-up. Both results suggest a possible role for the use of this physiotherapy technique to treat BPS patients. Longer follow-up and a larger number of patients are necessary to confirm these conclusions
 
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Publishing Date
2023-08-29
 
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