Existe associação entre os desconfortos no puerpério imediato e a via de parto? um estudo observacional / Is there association between the discomforts of the immediate postpartum period and type of delivery? an observational study

INTRODUÇÃO: A via de parto pode ser um fator determinante para o desenvolvimento de desconfortos no puerpério imediato. OBJETIVO: Identificar os desconfortos referidos pelas mulheres no puerpério imediato e compará-los entre as submetidas ao parto vaginal e à cesárea. MÉTODOS: Estudo analítico transversal desenvolvido em uma maternidade pública com levantamento de prontuários que continham informações da avaliação fisioterapêutica de puérperas atendidas no período de fevereiro a novembro de 2011. RESULTADOS: Foram incluídos 346 prontuários neste estudo. Queixas do puerpério imediato: dor abdominal (31,5%), edema (19,1%), lombalgia (18,2%), cervicalgia (9,8%) e desconforto em membros inferiores (5,8%). Cesárea foi a via de parto que acarretou maior desconforto, relacionando-se à presença de dor abdominal (p=0,001), cervicalgia (p=0,017) e edema (p=0,017). CONCLUSÃO: Os achados sugerem que as mulheres que passam por cesárea estão vulneráveis à maior morbidade durante o puerpério imediato em comparação ao parto vaginal.

INTRODUCTION: The type of delivery may be a determining fator for the development of discomfort in the immediate postpartum period. OBJECTIVE: To identify the discomfort related by women in the immediate postpartum period and to compare them among those submitted to vaginal delivery and cesarean. METHODS: Cross­sectional analytical study developed in a public maternity hospital with medical records that contained information of physical therapy evaluation of postpartum women attended from February to November 2011. RESULTS: A total of 346 records were included in this study. Immediate postpartum complaints: abdominal pain (31.5%), edema (19.1%), low back pain (18.2%), neck pain (9.8%) and discomfort in the lower limbs (5.8%). Cesarean was the mode of delivery that caused greater discomfort related to the presence of abdominal pain (p=0.001), neck pain (p=0.017) and edema (p=0.017). CONCLUSION: The findings suggest that women who undergo cesarean are vulnerable to greater morbidity compared to vaginal delivery during the immediate postpartum period.

Effects of low-level laser therapy on biceps braquialis muscle fatigue in young women.

OBJECTIVE: This study aims to investigate the effects of low-level laser therapy (LLLT) on biceps brachi muscular fatigue in 20 young females. BACKGROUND DATA: Exhausting physical activity leads to muscular fatigue, which could decrease muscular strength, and may cause impairment in motor control and muscle pain. Several biochemical and biophysical resources have been studied in an attempt to accelerate the recovery of muscle fatigue. Among these, LLLT is emphasized. METHODS: Twenty subjects were randomized in one laser group and one placebo group in two sessions of a crossover design experimental procedure; the second session taking place within 7 days of the first. In the first session, subjects underwent a collection of surface electromyographic (SEMG) data of the biceps brachii muscle, followed by active or placebo LLLT at the same muscle, followed then by another EMG sample of biceps brachii. Blood samples were collected five times during the experimental procedure. Second session procedures were identical to the first, with exception of LLLT, which was the opposite of the first session. The fatigue protocol consisted of 60 sec of elbow flexion-extension movement performed with 75% of one maximum repetition. Blood lactate, EMG fatigue, and the number of elbow flexion-extension repetitions during the fatigue protocol were used to evaluate the effects of laser therapy (808 nm wavelength, 100 mW output power, power density of 35.7 W/cm(2), 70 sec each point and 7 J/point on eight points). RESULTS: No statistical differences were found for eletromyographic fatigue and blood lactate values between groups. Mean numbers of elbow flexion-extension repetitions were 22.6 ± 7.58 after placebo, and 25.1 ± 9.89 after active LLLT group, but these differences were not statistically significant (p=0.342). CONCLUSIONS: LLLT had limited effects on delaying muscle fatigue in a young female sample, although a tendency was observed in the active laser group toward showing lower electromyography fatigue of biceps brachii muscle. No intergroup differences were found in the number of muscle contractions and lactate concentration.

Effect of 808 nm low-level laser therapy in exercise-induced skeletal muscle fatigue in elderly women.

Aging process involves several structural changes in muscle tissue which lead to decrease in musculoskeletal function. One of the most common physiological modifications is the increase in fatigability in elderly people, which leads to inability to maintain strength and motor control. In this context, low-level laser therapy (LLLT) has demonstrated positive results in reducing fatigue during physical exercise. Thus, this study aimed to investigate the effects of LLLT on skeletal muscle fatigue in elderly women. Twenty-four subjects divided in two groups entered a crossover randomized triple-blinded placebo-controlled trial. Active LLLT (808 nm wavelength, 100 mW, energy 7 J) or an identical placebo LLLT was delivered on the rectus femoris muscle immediately before a fatigue protocol. Subjects performed a fatigue protocol which consisted of voluntary isotonic contractions of knee flexion-extension performed with a load corresponding to 75 % of 1-MR (Maximum Repetition) during 60 s. Surface electromyography (SEMG) signals were recorded from rectus femoris muscle of dominant lower limb to evaluate peripheral fatigability using median frequency analysis of SEMG signal. The number of repetitions of flexion-extension during fatigue protocol was also compared between groups. The values of median frequency were used to calculate the slope coefficient. The results showed no difference in the slope comparing placebo LLLT and active LLLT groups (p = 0.293). However, a significant difference was observed in the number of repetitions between groups, after active LLLT, subjects demonstrated significantly higher number of repetitions (p = 0.047). In this study, LLLT was efficient in increasing the mean number of repetitions during knee flexion-extension exercise, although results have not shown delay electromyographic fatigue.