Effects of photobiomodulation therapy on the functional performance of healthy individuals: a systematic review with meta-analysis.

The aim of this study is to assess the effect of photobiomodulation therapy (PBMT) on functional performance concerning strength, fatigue, and functional capacity in healthy individuals. This systematic review with meta-analysis involved searches on data platforms and active searches of randomized clinical trials, focusing on PBMT as the sole intervention. Primary outcomes assessed included strength, fatigue, and functional capacity. Three reviewers screened studies by title and abstract using Rayyan, and data were extracted using a specific form. Bias risk was assessed using RoB2, and confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The RevMan was used for meta-analysis. Sixteen studies were included, totaling 340 individuals (183 males and 157 women). Most articles presented a low risk of bias. Variability was observed in device types and application domains, including wavelengths (655-905 nm), power (10-200 nW), energy (0.6-30 J per point), and time (30-100 s per point). PBMT improved fatigue recovery (mean difference: 5.87; 95% CI 3.83, 7.91). There was no enhancement in strength (peak torque: mean difference 12.40; 95% CI -5.55, 30.55; one-repetition maximum test: mean difference 39.97, 95% CI -2.44, 82.38; isometric and isokinetic strength: mean difference 2.77, 95% CI -14.90, 20.44) nor improvement in short-term (mean difference 0.67, 95% CI -0.58, 1.91) and long-term (mean difference 18.44, 95% CI -55.65, 92.54) functional capacity. PBMT may aid in favoring fatigue recovery in healthy individuals; however, there's no evidence to support PBMT enhancing strength or improving functional capacity.

Impact of Pelvic Floor Muscle Training Isolated and Associated with Game Therapy on Mixed Urinary Incontinence: A Randomized Controlled Trial.

Objective: To verify whether pelvic floor muscle training (PFMT) associated with game therapy (GT) can potentiate improvements in PFM pressure, urinary loss, and perception of improvement in women with mixed urinary incontinence (MUI). Materials and Methods: A randomized and blinded trial was conducted with 32 women aged between 45 to 70 years presenting diagnosis of MUI. They were randomly divided into two groups: PFMT group and PFMT+GT group. Interventions occurred twice a week during 8 weeks. Primary outcome was PFM pressure, assessed by manometry, and secondary outcomes were 1-hour pad-test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and patients global impression of improvement for incontinence (PGI-I). Two-way analysis of variance and post hoc Tukey analysis were performed. Results: Initially, no significant difference between groups was found in variables of age, body mass index, educational level, marital status, gynecological and obstetric variables, life habits, and sexual activity. Besides, at baseline clinical variables also showed similar results between groups for PFM pressure, 1-hour pad-test, and ICIQ-SF. Time-group interaction did not present statistically significant differences for PFM pressure (P = 0.56), 1-hour pad-test (P = 0.75), and ICIQ-SF (P = 0.30) in intergroup analysis. All women reported being "much better or better," considering the comparison of urinary complaints in the beginning and end of treatment. Conclusion: There were no statistically significant differences between groups for PFM pressure, 1-hour pad-test, and ICIQ-SF. However, both treatments proved to be effective for MUI symptoms. Perception of improvement was highly improved, according to women's report.

Game therapy a new approach to treat women facing mixed urinary incontinence: A study protocol.

AIMS: To describe a pelvic floor muscle training (PFMT) isolated and associated with game therapy (PFMT + GT) for women facing mixed urinary incontinence (MUI) during climacteric period. METHODS: To standardize a randomized controlled clinical trial intervention, a protocol was created, in an attempt to decrease women's symptomatology generated by MUI, through pelvic floor and abdomino-loin-pelvic muscles strength, and endurance. This study protocol will be composed of 32 volunteers, divided into two groups of 16. They will perform PFMT isolated or PFMT + GT, twice a week during 8 weeks. Interventions will last 40 minutes and will be divided into warming (5 minutes), training (30 minutes), and 5 minutes will be composed of resting time between exercises (1 minute each). Isolated PFMT sessions will be performed through four modalities of exercises: diaphragmatic, bridge, abdominal (plank), and pelvic mobility. PFMT + GT training will be carried out by using Wii Fit Plus games, such as Lotus Focus, Penguin Slide, Basic Step, and Hula Hoop from Wii equipment. Assessments will occur before, after, and 1 month after interventions. Vaginal manometry, 1-hour Pad Test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and Patient Global Intervention (PGI) will be used to evaluate the sample. CONCLUSIONS: It is expected greater increase on pelvic floor muscle (PFM) strength, endurance, vaginal pressure for PFMT + GG. Moreover, it is supposed that PFMT + GT volunteers present better treatment adherence due to games motivational inclusion.

Atividade física e função da musculatura do assoalho pélvico em mulheres climatéricas: um estudo transversal / Physical activity and pelvic floor muscles function in climacteric women: a transversal study

Introdução: A mulher climatérica apresenta fraqueza muscular que pode gerar disfunções pélvicas. Aparentemente a prática regular de atividade física nesse período promove uma melhora da função muscular global. Objetivo: avaliar a função da musculatura do assoalho pélvico (MAP) de acordo com nível de atividade física em mulheres climatéricas. Métodos: estudo observacional, analítico e transversal. A amostra foi composta por 457 mulheres divididas de acordo com o nível de atividade física. A coleta de dados ocorreu através da aplicação da ficha de avaliação, aplicação do Questionário Internacional de Atividade Física (IPAQ), e avaliação por meio da palpação vaginal e manometria da MAP. Para análise estatística foram usados os testes de Kolmogorov-Smirnov, ANOVA, qui-quadrado e correlação de Pearson. Resultados: As mulheres classificadas como muito ativas obtiveram uma pressão média de 45,24cmH2O, as ativas apresentaram 29,03cmH2O e as sedentárias 27,20cmH2O, com diferença estatística entre os grupos (p=0,003). Conclusão: Quanto mais ativa for a mulher climatérica, melhor será a função da MAP.

Introduction: climacteric woman has muscle weakness that can lead to pelvic floor dysfunctions. Apparently the regular practice of physical activity in this period promotes an improvement of the global muscular function. Objective: to evaluate the pelvic floor muscles (PFM) function according to the level of physical activity in climacteric women. Methods: observational, analytical and transversal study. The sample consisted of 457 women divided according to the level of physical activity. Data collection was made through the application of evaluation form and International Physical Activity Questionnaire (IPAQ), and vaginal palpation and manometry from PFM. For statistical analysis were used the Kolmogorov-Smirnov, ANOVA, chi-square and Pearson correlation tests. Results: The very active women obtained an average pressure of 45, 24cmH2O, the actives presented 29, 03cmH2O and the sedentary 27, 20cmH2O, with statistcal difference between the groups (p = 0,003). Conclusion: The more active the climacteric woman is, the better her PFM function will be.