Is There a Difference in Whole Body Standing Posture in Women With Urinary Incontinence Based on the Presence of Myofascial Dysfunction in the Pelvic Floor Muscles?

OBJECTIVE: The purpose of this study was to assess the prevalence of postural changes in women who had urinary incontinence (UI) with myofascial dysfunction (MD) and women who had UI without MD in the pelvic floor muscles (PFM). METHODS: A cross-sectional study was performed with 234 women who had UI and were at least 18 years old at the urogynecology outpatient clinic of a tertiary academic hospital. The International Consultation on Incontinence Questionnaire-Short Form and the International Consultation on Incontinence Questionnaire-Overactive Bladder were used to collect urinary data. Standing postural assessment was performed using photogrammetry in anterior, posterior, and right and left lateral views and was analyzed with Postural Assessment Software. MD was defined as pain of any intensity during palpation of the PFM, and the strength of these muscles was evaluated using the Modified Oxford Scale. RESULTS: The prevalence of MD in women with UI was 51.7% (121/234). Women with MD had significantly smaller angles in the horizontal alignment of the pelvis in the right-side view (mean [SD] = -11.9 [6.9] degrees and -9.6 [7.1] degrees), left-side view (-13.6 [6] degrees and -11.5 [6.6] degrees), and vertical alignment of the body in the left-side view (3 [1.5] degrees and 3.4 [1.5] degrees), showing anterior pelvic tilt and posterior displacement of the body. CONCLUSION: Women with UI and MD had greater anterior pelvic tilt and posterior displacement of the body than women without dysfunction. IMPACT: This study informs physical therapists and other health care professionals about the prevalence of MD in the pelvic floor muscles of women with UI and highlights the need to rule out MD, because it appears to be a concomitant impairment in women who self-report UI. During a postural screen, health care professionals should look for anterior pelvic tilt relative to horizon when evaluating posture in women with UI and MD. The findings of postural changes in women with MD and UI may influence the PFM assessment. LAY SUMMARY: Women with involuntary urinary loss, pain, and stiffness in the pelvic area may show changes in posture associated with this condition.

Análise morfológica a curto e longo prazo do músculo tibial anterior após contusão / Morphological analyse in a short and long-term of tibialis anterior muscle after contusion

Apesar de documentada a regeneração muscular após contusão, existe a preocupação dos profissionais envolvidos com a reabilitação na determinação do início do retorno das atividades dos atletas, uma vez que não existe relação direta entre regeneração e sinais e/ou sintomas indicativos de restabelecimento muscular. O objetivo deste trabalho foi analisar a curto e longo prazo o músculo tibial anterior (TA) de ratos após contusão. Vinte e oito ratos foram divididos em grupos controle e contusão. A contusão foi realizada por meio de carga (284g) liberada de altura de 30 cm sobre o músculo TA, sendo estes analisados após 3 e 28 dias. Cortes histológicos (10mmm) dos músculos congelados foram obtidos de micrótomo criostato e corados com Azul de Toluidina. Animais contundidos e analisados após 3 dias apresentaram alta incidência de sinais de fibras lesadas e/ou em regeneração. No grupo contundido e analisado após 28 dias os sinais predominantes foram de fibras regeneradas, embora tenha sido observada presença de fibras em regeneração. A presença de fibras musculares lesadas e em regeneração, 3 e 28 dias pós-lesão, sugere cuidados na prática desportiva tanto a curto quanto a longo prazo, a fim de se evitar recidivas a lesões